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A Study of the Effect of IW-1973 on the Exercise Capacity of Patients With Heart Failure With Preserved Ejection Fraction (HFpEF)

Phase 2
Completed
Conditions
Heart Failure With Preserved Ejection Fraction
Interventions
Drug: Placebo Oral Tablet
Registration Number
NCT03254485
Lead Sponsor
Akebia Therapeutics
Brief Summary

The objective of the CAPACITY-HFpEF study is to evaluate the safety and efficacy of IW-1973 compared with placebo when administered daily for approximately 12 weeks to patients with HFpEF. The study will evaluate the effect of oral IW-1973 on peak exercise capacity in patients with HFpEF, with or without permanent or persistent atrial fibrillation.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
196
Inclusion Criteria
  1. Patient is an ambulatory male or female ≥45 years old at the Screening Visit

  2. Patient has heart failure with ejection fraction (EF) of ≥40%

  3. Patient has a peak VO2 measuring <80% of age- and sex-adjusted normal values

  4. Patient has evidence in medical history supporting clinical heart failure syndrome consisting of at least 1 of the following:

    1. Hospitalization or emergency department visit for heart failure within the past year
    2. Elevated B-type natriuretic peptide (BNP) or N-terminal pro b-type natriuretic peptide (NT-proBNP) within the past 6 months
    3. Echocardiographic evidence within the past 12 months of at least 2 of the following: left ventricular (LV) hypertrophy, left atrial (LA) enlargement, or diastolic dysfunction
    4. Hemodynamic evidence of elevated filling pressures
  5. Patient meets at least 2 of the following criteria at the Screening Visit:

    1. Diagnosis of type 2 diabetes mellitus or prediabetes
    2. History of hypertension
    3. Body mass index (BMI) >30 kg/m2
    4. Age ≥70 years
Exclusion Criteria
  1. Patient has had acute coronary syndrome or percutaneous coronary intervention within 30 days before Randomization
  2. Patient has had cardiac transplantation or has cardiac transplantation planned during the study
  3. Patient has had cardiac artery bypass graft, cardiac mechanical support implantation, or other cardiac surgery in the 3 months before the Screening Visit or planned during the study
  4. Patient has severe chronic obstructive coronary disease as defined by chronic oxygen dependence
  5. Patient had had heart failure hospitalization with discharge within 30 days before the Screening Visit
  6. Patient has a history of clinically significant hypersensitivity or allergies to any of the inactive ingredients contained in the active or placebo drug products
  7. Patient has previously received IW-1973 in a study, or received an investigational drug during the 30 days or 5 half lives of that investigational drug (whichever is longer) before the Screening Visit, or is planning to receive another investigational drug at any time during the study
  8. Patient is taking specific inhibitors of phosphodiesterase 5 (PDE5), nonspecific inhibitors of PDE5, any supplements for the treatment of erectile dysfunction, riociguat, or nitrates or nitric oxide (NO) donors in any form
  9. Patient is taking strong cytochrome P450 3A (CYP3A) inhibitors
  10. Women of childbearing potential must have a negative pregnancy test prior to randomization and must agree to use protocol-specified contraception from the Screening Visit through 60 days after the final dose of study drug
  11. Male patients must be surgically sterile by vasectomy (conducted ≥60 days before the Screening Visit or confirmed via sperm analysis) or must agree to use protocol-specified contraception from the Screening Visit through 60 days after the final dose of study drug
  12. Other exclusion criteria per protocol

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
IW-1973 High DoseIW-1973-
PlaceboPlacebo Oral TabletPlacebo to match experimental drug
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Peak Oxygen Consumption (VO2) at Week 12Baseline and Week 12

Peak VO2 was obtained from Cardiopulmonary Exercise Test (CPET), which was used to evaluate the effect of praliciguat on peak exercise capacity. Baseline is defined as the last non-missing measurement prior to the first dose of study drug. Change from Baseline was calculated by subtracting Baseline value from the Week 12 value. Data were analyzed using an analysis of covariance (ANCOVA) model with treatment group and atrial fibrillation stratification factors as categorical variable terms and Baseline peak VO2 value as a covariate. Milliliter O2 per kilogram per minute = mL O2/kg/min

Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Study Drug-related TEAEsDay 1 up to Day 113

An adverse event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. TEAEs are defined as those adverse events (AEs) that started or worsened in severity after the administration of study drug. Causality relationship to study drug was per Investigator assessment. Number of participants with TEAEs and study drug-related TEAEs is presented.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Ventilatory Efficiency at Week 12Baseline and Week 12

Ventilatory efficiency was defined as minute ventilation/carbon dioxide (VE/VCO2) slope, production and was obtained from CPET. Baseline is defined as the last non-missing measurement prior to the first dose of study drug. Change from Baseline was calculated by subtracting Baseline value from the Week 12 value. Data were analyzed using an ANCOVA model with treatment group, atrial fibrillation stratification factor and peak VO2 stratification factor as categorical variable terms and baseline value as a covariate.

Change From Baseline in 6-minute Walk Test (6MWT) Distance at Week 12Baseline and Week 12

6MWT was a simple assessment of everyday functional capacity and provided a global evaluation of the organ/physiologic systems involved in exercise. 6MWT assessed the distance travelled in 6 minutes, measured at approximately the same time of day. Baseline is defined as the last non-missing measurement prior to the first dose of study drug. Change from Baseline was calculated by subtracting Baseline value from the Week 12 value. Data were analyzed using an ANCOVA model with treatment group, atrial fibrillation stratification factor and peak VO2 stratification factor as categorical variable terms and Baseline value as a covariate.

CPET Responders at Week 12At Week 12

CPET responders were defined as participants who improved by at least 1.5 mL O2/kg/min in peak VO2 from Baseline to Week 12. Baseline is defined as the last non-missing measurement prior to the first dose of study drug.

Trial Locations

Locations (60)

University of Arizona

🇺🇸

Tucson, Arizona, United States

Stanford University

🇺🇸

Palo Alto, California, United States

Valley Clinical Trials

🇺🇸

Northridge, California, United States

JEHM

🇺🇸

National City, California, United States

Harbor UCLA Medical Center

🇺🇸

Torrance, California, United States

Holy Cross Hospital

🇺🇸

Fort Lauderdale, Florida, United States

South Denver Cardiology Associates

🇺🇸

Littleton, Colorado, United States

East Coast Institute for Research

🇺🇸

Jacksonville, Florida, United States

New Generation of Medical Research

🇺🇸

Hialeah, Florida, United States

Progressive Medical Research

🇺🇸

Port Orange, Florida, United States

Broward Research Center

🇺🇸

Pembroke Pines, Florida, United States

Unity Point Health - Methodist Hospital

🇺🇸

Peoria, Illinois, United States

Lousiana Heart Center

🇺🇸

Bogalusa, Louisiana, United States

Michigan Heart

🇺🇸

Ypsilanti, Michigan, United States

Washington University

🇺🇸

Saint Louis, Missouri, United States

VA Healthcare John Cochran Medical Center

🇺🇸

Saint Louis, Missouri, United States

ProMedica Toledo Hospital

🇺🇸

Toledo, Ohio, United States

Mount Sinai School of Medicine

🇺🇸

New York, New York, United States

Oklahoma Heart Institute

🇺🇸

Tulsa, Oklahoma, United States

Research Institute of Lancaster General Health

🇺🇸

Lancaster, Pennsylvania, United States

PeaceHealth, Sacred Heart Physicians

🇺🇸

Springfield, Oregon, United States

University of Vermont Medical Center

🇺🇸

Burlington, Vermont, United States

Madigan Army Medical Center

🇺🇸

Tacoma, Washington, United States

London Health Sciences Centre

🇨🇦

London, Ontario, Canada

CIUSSS de l'Estrie - CHUS

🇨🇦

Sherbrooke, Quebec, Canada

Institut Universitaire de Cardiologie et de Pneumologie De Quebec

🇨🇦

Québec, Canada

Axis Clinical Trials

🇺🇸

Los Angeles, California, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Tufts Medical Center

🇺🇸

Boston, Massachusetts, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Boston University School of Medicine

🇺🇸

Boston, Massachusetts, United States

Ohio State University Medical Center (OSUMC)

🇺🇸

Columbus, Ohio, United States

North Dallas Research Associates

🇺🇸

Dallas, Texas, United States

Texas Health Research and Education Insitute

🇺🇸

Dallas, Texas, United States

Southwest Family Medicine Associates

🇺🇸

Dallas, Texas, United States

Baylor University Medical Center

🇺🇸

Dallas, Texas, United States

University of Texas Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

Mount Sinai Hospital

🇨🇦

Toronto, Ontario, Canada

PCRS Network, LLC

🇺🇸

Miami, Florida, United States

Franciscan Physician Network - Indiana Heart Physicians

🇺🇸

Indianapolis, Indiana, United States

Drexel University College of Medicine

🇺🇸

Philadelphia, Pennsylvania, United States

The Valley Hospital

🇺🇸

Ridgewood, New Jersey, United States

Cardiology and Medicine Clinic

🇺🇸

Little Rock, Arkansas, United States

St. Luke's Regional Medical Center

🇺🇸

Boise, Idaho, United States

Lahey Clinic

🇺🇸

Burlington, Massachusetts, United States

Ecogene-21

🇨🇦

Chicoutimi, Quebec, Canada

Arizona Arrhythmia Research Center

🇺🇸

Phoenix, Arizona, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Aurora Denver Cardiology

🇺🇸

Denver, Colorado, United States

University of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

South Oklahoma Heart Research

🇺🇸

Oklahoma City, Oklahoma, United States

Newton Clinical Research

🇺🇸

Oklahoma City, Oklahoma, United States

Oregon Health & Science University (OHSU)

🇺🇸

Portland, Oregon, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

Schnitzler Cardiovascular Consultants

🇺🇸

San Antonio, Texas, United States

Virginia Commonwealth University Medical College of Virginia

🇺🇸

Richmond, Virginia, United States

Unity Point Health

🇺🇸

Madison, Wisconsin, United States

University of Wisconsin - Madison

🇺🇸

Madison, Wisconsin, United States

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

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