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REGN5381 in Heart Failure Adult Participants With Elevated Pulmonary Capillary Wedge Pressure

Phase 2
Active, not recruiting
Conditions
Heart Failure
Interventions
Drug: Matching Placebo
Registration Number
NCT05353166
Lead Sponsor
Regeneron Pharmaceuticals
Brief Summary

This study is researching an experimental drug called REGN5381, further referred to as study drug. The study is focused on adult participants with heart failure that, in the opinion of the study doctor, have a clinical indication for right heart catheterization (RHC). The aim of the study is to evaluate the safety and tolerability of the study drug.

The study is looking at several other research questions, including:

* What side effects may happen from taking the study drug

* How much study drug is in the blood at different times

* Whether the body makes antibodies against the study drug (which could make the drug less effective or could lead to side effects)

Detailed Description

Note: Group A has stopped enrolling and Group B will not enroll participants

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
59
Inclusion Criteria
  1. Body mass index (BMI) between 18 and 35 kg/m^2, inclusive, rounded to the nearest whole number
  2. Ambulatory participants with New York Heart Association (NYHA) class II/III heart failure and at least 1 sign and/or symptom of congestion (eg, dyspnea on exertion, worsening edema, orthopnea, etc.)
  3. Left ventricular ejection fraction (LVEF) ≥20 % and <50% on echocardiogram (ie, HFrEF participants) within 90 days prior to randomization (only for HFrEF participants in Group A and Group B).
  4. Participants who, in the opinion of the investigator, require a right heart catheterization (not applicable for HFrEF patients not taking sacubitril/valsartan [Group A]).
  5. Left ventricular ejection fraction (LVEF) ≥50% on echocardiogram (ie, HFpEF participants) within 90 days prior to randomization (only for HFpEF participants in Group C)
  6. NT-proBNP >1000 pg/mL or Brain Natriuretic Peptide (active form) (BNP) >300 pg/mL as described in the protocol within 30 days prior to randomization measured by the local laboratory (only for HFrEF participants [Group A and Group B]).
  7. Pulmonary capillary wedge pressure (PCWP) ≥15 mmHg and right artrial pressure (RAP) >5 mmHg on right heart catheterization (RHC) the morning of anticipated study drug dose administration (not applicable for HFrEF participants not taking sacubitril/valsartan [Group A] as described in the protocol).
  8. Systolic blood pressure (SBP) ≥110 mmHg at the screening visit and on day -1
  9. Hematocrit >30% at the screening visit and day -1

Key

Exclusion Criteria
  1. Currently taking IV vasodilators and/or inotropes
  2. Taking sacubitril/valsartan (only for HFrEF and HFpEF participants not taking sacubitril/valsartan [Group A and Group C, respectively])
  3. Taking a phosphodiesterase (PDE) inhibitor (eg, sildenafil), or a soluble guanylate cyclase stimulator (SGCS; ie, vericiguat) within 2 weeks of the screening visit or planning on taking valsartan/sacubitril, a PDE inhibitor, or a SGCS at any point during the study
  4. More than moderate valvular regurgitation/stenosis (ie, moderate-to-severe or severe) on echocardiogram within 90 days prior to randomization
  5. Known infiltrative or hypertrophic cardiomyopathy
  6. Acute coronary syndrome within prior 6 months of randomization
  7. History of cardiac arrest
  8. Cardiac surgery within 3 months of randomization
  9. Pacemaker or defibrillator placement within prior 30 days of randomization
  10. Severe chronic obstructive pulmonary disease (COPD) (defined as Forced Expiratory Volume in 1st second [FEV1] <50% of predicted or Global Initiative for Chronic Obstructive Lung Disease [GOLD] 3 or 4)
  11. Pulmonary arterial hypertension (World Health Organization [WHO] Group 1) and any medical history at any time of more than moderate pulmonary hypertension (ie, moderate-to-severe, or severe pulmonary hypertension, as described in the protocol
  12. Congenital heart disease (repaired or unrepaired)
  13. Inability to lie flat for cardiac catheterization

Note: Other protocol-defined Inclusion/ Exclusion Criteria apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group AMatching PlaceboRandomized 1:1; limited to participants with heart failure with reduced ejection fraction (HFrEF) not taking sacubitril/valsartan
Group CMatching PlaceboRandomized 1:1; limited to participants with heart failure with preserved ejection fraction (HFpEF) not taking sacubitril/valsartan
Group BMatching PlaceboRandomized 1:1; limited to participants with HFrEF taking sacubitril/valsartan
Group CREGN5381Randomized 1:1; limited to participants with heart failure with preserved ejection fraction (HFpEF) not taking sacubitril/valsartan
Group AREGN5381Randomized 1:1; limited to participants with heart failure with reduced ejection fraction (HFrEF) not taking sacubitril/valsartan
Group BREGN5381Randomized 1:1; limited to participants with HFrEF taking sacubitril/valsartan
Primary Outcome Measures
NameTimeMethod
Incidence and severity of treatment-emergent adverse events (TEAEs)Through the end-of-study (EOS) visit up to 126 days post-dose
Secondary Outcome Measures
NameTimeMethod
Change from baseline in pulmonary capillary wedge pressure (PCWP)Over 6 hours post-dose administration

In cohorts undergoing right heart catheterization

Change from baseline right atrial pressure (RAP)Over 6 hours post-dose administration

In cohorts undergoing right heart catheterization

Change from baseline cardiac output (CO)Over 6 hours post-dose administration

In cohorts undergoing right heart catheterization

Change from baseline systemic vascular resistance (SVR)Over 6 hours post-dose administration

In cohorts undergoing right heart catheterization

Change from baseline mean pulmonary artery pressure (mPAP)Over 6 hours post-dose administration

In cohorts undergoing right heart catheterization

Change from baseline pulmonary vascular resistance (PVR)Over 6 hours post-dose administration

In cohorts undergoing right heart catheterization

Change from baseline in systolic blood pressure (SBP)Over the first 6 hours, 24 hours post-dose administration (day 1), through the EOS visit up to 126 days post-dose
Change from baseline in diastolic blood pressure (DBP)Over the first 6 hours, 24 hours post-dose administration (day 1), through the EOS visit up to 126 days post-dose
Change from baseline in mean arterial pressure (MAP)Over the first 6 hours, 24 hours post-dose administration (day 1), through the EOS visit up to 126 days post-dose
Change from baseline in pulse rate (PR)Over the first 6 hours, 24 hours post-dose administration (day 1), through the EOS visit up to 126 days post-dose
Change from baseline in N-terminal pro-brain natriuretic peptide (NT-proBNP)To 6 hours, 24 hours post-dose administration (day 1), through the EOS visit up to 126 days post-dose
Immunogenicity, as measured by anti-drug antibodies (ADA) to REGN5381Through the EOS visit, up to 126 days post-dose
Concentrations of REGN5381 in serumThrough the EOS visit, up to 126 days post-dose

Trial Locations

Locations (1)

ARENSIA Exploratory Medicine at the Republican Clinical Hospital

🇲🇩

Chișinău, Moldova, Republic of

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