MedPath

Evaluating Ventricular Arrhythmia in Subjects With Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy-Defibrillator

Phase 2
Completed
Conditions
Ventricular Arrhythmia
Interventions
Drug: Eleclazine
Drug: Placebo to match eleclazine
Registration Number
NCT02104583
Lead Sponsor
Gilead Sciences
Brief Summary

The primary objective of this study is to evaluate the effect of eleclazine (GS-6615) compared to placebo on the overall occurrence of appropriate implantable cardioverter-defibrillator (ICD) interventions (antitachycardia pacing \[ATP\] or shock) in adults with ICD or cardiac resynchronization therapy-defibrillator (CRT-D).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
313
Inclusion Criteria
  • Have an ICD or CRT-D implanted for primary or secondary prevention and at least one ICD intervention for ventricular tachycardia/ventricular fibrillation (VT/VF) [shock or ATP] within 60 days prior to screening or a documented VT/VF episode (prior to implantation) within 60 days prior to screening
  • Use of highly effective contraception methods if female of childbearing potential or sexually active male
  • Must be hemodynamically stable

Key

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Exclusion Criteria
  • New York Heart Association (NYHA) Class IV heart failure
  • Myocardial infarction, unstable angina, coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI) within 4 weeks prior to screening or during the screening period before randomization
  • Hemodynamically significant primary obstructive valvular disease
  • History of congenital heart disease
  • Inherited arrhythmia such as Brugada syndrome. Individuals with long QT syndrome Type 3 (LQT-3) or hypertrophic cardiomyopathy (HCM) may be considered.
  • Individuals who are being considered for cardiac transplantation and are on a cardiac transplant list
  • History of seizures or epilepsy
  • Cardiac ablation within 3 months prior to screening or planned cardiac ablation during the study
  • Severe renal impairment
  • Abnormal liver function tests
  • Currently taking Class I and Class III antiarrhythmic drugs; such medications should be discontinued 5 half-lives (or 28 days for chronic use of amiodarone) prior to randomization
  • Currently taking drugs or products that are strong inhibitors or inducers of CYP3A; such medications should be discontinued 5 half-lives prior to randomization
  • Currently taking ranolazine; ranolazine should be discontinued at least 7 days prior to randomization
  • Females who are pregnant or are breastfeeding
  • Individuals with a subcutaneous ICD
  • Body mass index (BMI) ≥ 36 kg/m^2

Note: Other protocol defined Inclusion/Exclusion criteria may apply

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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Eleclazine 3 mgEleclazineParticipants will receive a single loading dose of eleclazine 30 mg on Day 1, followed by eleclazine 3 mg daily as maintenance for up to approximately 20 months.
Eleclazine 6 mgEleclazineParticipants will receive a single loading dose of eleclazine 30 mg on Day 1, followed by eleclazine 6 mg daily as maintenance for up to approximately 20 months.
PlaceboPlacebo to match eleclazineParticipants will receive a single loading dose of placebo to match eleclazine on Day 1, followed by placebo to match eleclazine once daily for up to approximately 20 months.
Primary Outcome Measures
NameTimeMethod
Overall Occurrence (Total Number) of Appropriate Implantable Cardioverter-Defibrillator Device (ICD) Interventions (Anti-Tachycardia Pacing or Shock) Through Week 24Randomization up to 24 weeks
Secondary Outcome Measures
NameTimeMethod
Overall Occurrence (Total Number) of Appropriate ICD Interventions (ATP or Shock) Through End of StudyRandomization up to 22 months
Change From Baseline in Premature Ventricular Complex (PVC) Count as Assessed by Continuous Electrocardiogram (cECG) MonitoringBaseline to Week 12

PVC count per 48 hours was obtained from cECG readings at Baseline and Week 12. Change in PVC from baseline was measured in units of number of episodes/48 hours. Change from baseline was calculated as the value at Week 12 minus the value at Baseline.

Time From First Dose of Study Drug to the First Occurrence of CV Hospitalization, Emergency Room (ER) Visit, or CV DeathFrom first dose of study drug up to 22 months

CV hospitalizations, CV ER visits, and CV deaths were determined through the adjudication by the CEC. The events that were adjudicated as undetermined were considered cardiovascular related. For each participant, the time from the first dose of study drug to the first CV hospitalization or CV ER visit through the last day on study or, in absence of CV hospitalizations or CV ER visits, to a CV death were derived as (first event date - first dose date + 1). The participants without CV hospitalizations, CV ER visits, or CV death were censored at the last day on study. As planned, data was reported only for Cohort 2 and combined Cohorts 1 and 2. Time to first occurrence of CV hospitalization, ER visit, or CV death was analyzed using KM estimates.

Change From Baseline in Nonsustained Ventricular Tachycardia (nsVT) Count as Assessed by Continuous cECG MonitoringBaseline to Week 12

The count of nsVTs per 48 hours was obtained from cECG readings at Baseline and Week 12. Change in nsVT from baseline was measured in units of number of episodes/48 hours. Change from baseline was calculated as the value at Week 12 minus the value at Baseline.

Overall Occurrence (Total Number) of Ventricular Tachycardia/Ventricular Fibrillation (VT/VF) (Treated or Untreated) Through Week 24 and End of StudyRandomization up to Week 24; Randomization up to end of study (up to 22 months)
Overall Occurrence (Total Number) of Electrical Storm Through Week 24 and End of StudyRandomization up to Week 24; Randomization up to end of study (up to 22 months)

An electrical storm was defined as ≥ 3 separate episodes of ventricular arrhythmia within a 24-hour period terminated by ICD.

Overall Occurrence (Total Number) of Inappropriate ICD Interventions Through Week 24 and End of StudyRandomization up to Week 24; Randomization up to end of study (up to 22 months)
Change in Left Ventricular Systolic and Diastolic Function as Assessed by Left Ventricular Ejection Fraction (LVEF)Baseline to Week 12; Baseline to Week 24

LVEF is a measure of how much blood is pumped out of the left ventricle of the heart. Change from baseline was calculated as the value at Week 12 or 24 minus the value at Baseline.

Time From First Dose of Study Drug to the First Occurrence of Appropriate ICD Interventions (ATP or Shock) or Cardiovascular (CV) DeathFrom first dose of study drug up to 22 months

CV deaths were determined through the adjudication by an external independent clinical event committee (CEC). The deaths that were adjudicated as undetermined were considered cardiovascular related. For each participant, the time from the first dose of study drug to the beginning of the earliest appropriate ICD intervention through the last day on study or, in absence of appropriate ICD interventions, to a CV death was derived as (first event date - first dose date + 1). The participants without appropriate ICD interventions or CV death were censored at the last day on study. As planned, data was reported only for Cohort 2 and combined Cohorts 1 and 2. Time to first occurrence of an appropriate ICD interventions or CV death was analyzed using Kaplan-Meier (KM) estimates.

Trial Locations

Locations (84)

Cardiovascular Associates of Mesa

🇺🇸

Mesa, Arizona, United States

Ohiohealth Corporation

🇺🇸

Columbus, Ohio, United States

Charlotte Heart and Vascular Institute

🇺🇸

Port Charlotte, Florida, United States

South Denver Cardiology Associates, PC

🇺🇸

Littleton, Colorado, United States

Mid Michigan Medical Center - Midland

🇺🇸

Midland, Michigan, United States

Magyar Honvedseg Egeszsegugyi Kozpont

🇭🇺

Budapest, Hungary

Great Falls Clinic

🇺🇸

Great Falls, Montana, United States

Florida Medical Clinic PA

🇺🇸

Zephyrhills, Florida, United States

The Heart Institute at Largo

🇺🇸

Largo, Florida, United States

Coastal Cardiology Consultants PA dba Heart and Vascular Institute of Florida

🇺🇸

Clearwater, Florida, United States

Athens Regional Specialty Services

🇺🇸

Athens, Georgia, United States

Capital Area Research

🇺🇸

Camp Hill, Pennsylvania, United States

Radin Cardiovascular Medical Associates

🇺🇸

Newport Beach, California, United States

Budai Irgalmasrendi Kórház

🇭🇺

Budapest, Hungary

Long Beach Memorial Hospital

🇺🇸

Long Beach, California, United States

University of Heidelberg

🇩🇪

Heidelberg, Germany

Catharina ziekenhuis

🇳🇱

Eindhoven, Netherlands

St.Antonius Hospital

🇳🇱

Nieuwegein, Netherlands

State Hospital for Cardiology

🇭🇺

Balatonfüred, Hungary

Medical University of Lodz

🇵🇱

Lodz, Poland

Medical University Wroclaw

🇵🇱

Wroclaw, Poland

Medizinische Klinik und Poliklinik I Abteilung für Kardiologie

🇩🇪

Munich, Germany

New York Methodist Hospital

🇺🇸

Brooklyn, New York, United States

Gemeinschaftspraxis für Innere Medizin

🇩🇪

Riesa, Germany

HaEmek Medical Center

🇮🇱

Afula, Israel

Kingston General Hospital

🇨🇦

Kingston, Ontario, Canada

Onze Lieve Vrouwe Gasthuis

🇳🇱

Amsterdam, Netherlands

Isala

🇳🇱

Zwolle, Netherlands

Collegium Medicum Uniwersytetu Jagiellonskiego

🇵🇱

Kraków, Poland

Indywidualna Specjalistyczna Praktyka Lekarska Jarosław Kaźmierczak

🇵🇱

Szczecin, Poland

Warszawski Uniwersytet Medyczny

🇵🇱

Warszawa, Poland

Chum Hotel Dieu

🇨🇦

Montreal, Quebec, Canada

Tel Aviv University/Meir Medical Center

🇮🇱

Israel, Israel

University Medical Center Goettingen

🇩🇪

Goettingen, Germany

Fakultni nemocnice Olomouc

🇨🇿

Olomouc, Czechia

Charles University Hospital Královské Vinohrady

🇨🇿

Prague, Czechia

Amphia ziekenhuis

🇳🇱

Breda, Netherlands

Zala Megyei Kórház

🇭🇺

Zalaegerszeg, Hungary

Sheba Medical Center

🇮🇱

Ramat Gan, Israel

Galilee Medical Center

🇮🇱

Nahariya, Israel

Kaplan Medical Center

🇮🇱

Rehovot, Israel

Maastricht University Medical Center

🇳🇱

Maastricht, Netherlands

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Mc Tronik Specjalistyczny Gabinet Kontroli Stymulatorow Serca Dr N. Med. Michal Chudzik

🇵🇱

Lódz, Poland

NZOZ Sopockie Centrum badan Kardiolog.ProCordis pawel Miekus

🇵🇱

Sopot, Poland

Samodzielny Publiczny Szpital Kliniczny nr 7 Slaskiego Uniwersytetu Medycznego w Katowicach Górnosla

🇵🇱

Katowice, Poland

Semmelweis Egyetem

🇭🇺

Budapest, Hungary

Instytut Kardiologii im Prymasa Tysiaclecia Kardynala Stefana Wyszynskiego

🇵🇱

Warsaw, Poland

Aalborg University Hospital

🇩🇰

Aalborg, Denmark

Rigshospitalet, The Heart Center

🇩🇰

Copenhagen, Denmark

Gentofte Hospitak, Deparment of Cardiology

🇩🇰

Hellerup, Denmark

Methodist Physicians Clinic Heart Consultants

🇺🇸

Omaha, Nebraska, United States

Durham VA Medical Center

🇺🇸

Durham, North Carolina, United States

Good Samaritan Hospital

🇺🇸

Los Angeles, California, United States

Atlantic Clinical Research Collaborative

🇺🇸

Atlantis, Florida, United States

Michigan Cardiovascular Institute

🇺🇸

Saginaw, Michigan, United States

Aultman Hospital

🇺🇸

Canton, Ohio, United States

West Houston Area Clinical Trial Consultants

🇺🇸

Houston, Texas, United States

Care New England Health Care, Kent Hospital

🇺🇸

Warwick, Rhode Island, United States

Stroobants Cardiovascular Center

🇺🇸

Lynchburg, Virginia, United States

Virginia Heart Group Ltd

🇺🇸

Falls Church, Virginia, United States

Odense University Hospital/Department of Cardiology

🇩🇰

Odense C, Denmark

Klinikum der Universität Regensburg

🇩🇪

Regensburg, Germany

Hadassah Medical Center

🇮🇱

Jerusalem, Israel

Shaare Zedek Medical Center

🇮🇱

Jerusalem, Israel

Indywidualna Specjalistyczna Praktyka Lekarska Andrzej Lubinski

🇵🇱

Lódz, Poland

Szpital Wolski im Dr Anny Gostynskiej SP ZOZ

🇵🇱

Warszawa, Poland

Clearwater Cardiovascular and Interventional Consultants

🇺🇸

Clearwater, Florida, United States

CardioVascular Institute

🇺🇸

Wormleysburg, Pennsylvania, United States

Cardiovascular Research Institute of Dallas

🇺🇸

Dallas, Texas, United States

Centre Hospitalier Universitaire de Sherbrooke CHUS

🇨🇦

Sherbrooke, Quebec, Canada

The University of Vermont Medical Center

🇺🇸

Burlington, Vermont, United States

New Mexico Hear Institute

🇺🇸

Albuquerque, New Mexico, United States

QEII Health Sciences Centre

🇨🇦

Halifax, Canada

Inova Fairfax Hospital

🇺🇸

Falls Church, Virginia, United States

Marshfield Clinic Research Foundation

🇺🇸

Marshfield, Wisconsin, United States

Carilion Roanoke Memorial Hospital

🇺🇸

Roanoke, Virginia, United States

Volunteer Research Group

🇺🇸

Knoxville, Tennessee, United States

Vivantes Humboldt Klinikum

🇩🇪

Berlin, Germany

Rambam Health Care Campus

🇮🇱

Haifa, Israel

Regional Cardiology Associates

🇺🇸

Sacramento, California, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Washington Adventist Hospital

🇺🇸

Takoma Park, Maryland, United States

Seton Heart Institute

🇺🇸

Austin, Texas, United States

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