Clinical Trials/NCT05556343

NCT05556343

Terminated

Phase 2

A Phase 2a, Open-label, Pilot Study to Evaluate Efficacy, Pharmacokinetics, Pharmacodynamics, Safety, and Tolerability of MYK-224 in Participants With Symptomatic Hypertrophic Cardiomyopathy and Left Ventricular Outflow Tract Obstruction (MERCUTIO)

Bristol-Myers Squibb25 sites in 4 countries36 target enrollmentJanuary 18, 2023

ConditionsCardiomyopathy, Hypertrophic

InterventionsMYK-224

DrugsMYK-224

Overview

Phase: Phase 2
Intervention: MYK-224
Conditions: Cardiomyopathy, Hypertrophic
Sponsor: Bristol-Myers Squibb
Enrollment: 36
Locations: 25
Primary Endpoint: Incidence of appropriate implantable cardioverter defibrillator therapy and resuscitated cardiac arrest
Status: Terminated
Last Updated: 8 months ago

Overview Investigators Eligibility Criteria Arms & Interventions Outcomes Sites Similar Trials

Overview

Brief Summary

The purpose of this study is to characterize the safety, tolerability, efficacy, pharmacokinetics (PK), and pharmacodynamics (PD) of MYK-224 in participants with obstructive Hypertrophic Cardiomyopathy (oHCM)

Registry

clinicaltrials.gov

Start Date

January 18, 2023

End Date

February 27, 2025

Last Updated

8 months ago

Study Type

Interventional

Study Design

Parallel

Sex

All

Investigators

Sponsor

Bristol-Myers Squibb

Responsible Party

Sponsor

Eligibility Criteria

Inclusion Criteria

•Has adequate acoustic windows, to enable accurate TTEs as determined by the echocardiography core laboratory.
•Men or women diagnosed with oHCM consistent with current American College of Cardiology Foundation/American Heart Association and European Society of Cardiology guidelines, satisfying both of the following criteria:
•Has unexplained left ventricular (LV) hypertrophy with nondilated ventricular chambers in the absence of other cardiac (eg, hypertension, aortic stenosis) or systemic disease and with maximal LV wall thickness ≥ 15 millimeter (mm) (or ≥ 13 mm with positive family history of hypertrophic cardiomyopathy or with a known disease-causing mutation), as determined by core laboratory interpretation.
•- Has a LVOT peak gradient during screening as assessed by echocardiography of ≥ 50 millimeters of mercury (mm Hg) at rest, or ≥ 30 mm Hg at rest and ≥ 50 mm Hg with Valsalva maneuver (confirmed by echocardiography core laboratory interpretation).
•Has resting LVEF ≥ 60% at the Screening visit as determined by echocardiography core laboratory.
•New York Heart Association (NYHA) functional class II or III symptoms at screening.
•Has a valid measurement of LVOT post-exercise peak gradient at screening as determined by echocardiography core laboratory.

Exclusion Criteria

•Presence of any medical condition that precludes exercise stress testing.
•History of syncope or sustained ventricular tachyarrhythmia within 6 months prior to screening.
•Known infiltrative or storage disorder causing cardiac hypertrophy that mimics HCM, such as Fabry disease, amyloidosis, or Noonan syndrome with left ventricular hypertrophy.
•Prior treatment with mavacamten or aficamten. An exception may be made in cases where myosin inhibitor use was not within 4 months of the Screening visit, and with the agreement of both the Investigator and the Medical Monitor.
•Has been successfully treated with invasive septal reduction (surgical myectomy or percutaneous alcohol septal ablation \[ASA\]) within 6 months prior to Screening or plans to have either of these treatments during the study (Note: Individuals with an unsuccessful myectomy or percutaneous ASA procedure performed \> 6 months prior to Screening may be enrolled if study eligibility criteria for LVOT gradient criteria are met).
•Implantable cardioverter-defibrillator (ICD) placement or pulse generator change within 2 months prior to screening or planned new ICD placement during the study (pulse generator changes, if needed during the study are allowed).
•Has a history of resuscitated sudden cardiac arrest (any time) or known history of appropriate implantable cardioverter-defibrillator (ICD discharge for life-threatening ventricular arrhythmia within 6 months prior to screening.
•Has paroxysmal, atrial fibrillation with atrial fibrillation present per the Investigator's evaluation of the participant's ECG at the time of Screening.
•Has persistent or permanent atrial fibrillation not on anticoagulation for at least 4 weeks prior to Screening and/or not adequately rate controlled within 6 months prior to Screening (Note: Participants with persistent or permanent atrial fibrillation who are anticoagulated and adequately rate-controlled are allowed).
•Has QT interval with Fridericia correction (QTcF) \> 500 msec when QRS interval \< 120 msec or QTcF \> 520 msec when QRS ≥ 120 msec if participant has left bundle branch block or any other 12-lead ECG abnormality considered by the investigator to pose a risk to participant safety (eg, second-degree atrioventricular block type II).

Arms & Interventions

Cohort 1

Participants will receive MYK-224 either as a monotherapy or in combination with standard-of-care consisting of a beta-blocker. Participants who complete Cohort 1 will be eligible for an optional open label extension period

Intervention: MYK-224

Cohort 2

Participants will receive MYK-224 in combination with standard-of-care consisting of either a calcium channel blocker or disopyramide (which is given in combination with either a beta-blocker or calcium channel blocker). Participants who complete Cohort 2 will be eligible for an optional open label extension period

Intervention: MYK-224

Outcomes

Primary Outcomes

Incidence of appropriate implantable cardioverter defibrillator therapy and resuscitated cardiac arrest

Time Frame: Up to 53 weeks

Incidence of vital sign abnormalities

Time Frame: Up to 53 weeks

Incidence of transthoracic echocardiogram (TTE) abnormalities

Time Frame: Up to 53 weeks

Incidence of adverse events (AEs)

Time Frame: Up to 53 weeks

Incidence of arrhythmias

Time Frame: Up to 53 weeks

Incidence of physical examination abnormalities

Time Frame: Up to 53 weeks

Incidence of electrocardiogram (ECG) abnormalities

Time Frame: Up to 53 weeks

Incidence of clinical laboratory abnormalities

Time Frame: Up to 53 weeks

Secondary Outcomes

Concentration-response relationship between MYK-224 pharmacokinetics (PK) and LVOT peak gradients(Up to 45 weeks)
Change in left ventricular outflow tract (LVOT) peak gradient (post-exercise, resting, and Valsalva) from baseline to end of treatment(Up to 45 weeks)
Summary of plasma concentrations of MYK-224(Up to 53 weeks)
Proportion of participants achieving a resting LVOT peak gradient of < 30 mm Hg and a Valsalva LVOT peak gradient < 50 mm Hg at end of treatment(Up to 45 weeks)
Concentration-response relationship between MYK-224 PK and echocardiographic parameters of systolic and diastolic function(Up to 45 weeks)