A PHASE II STUDY ASSESSING RANOLAZINE IN ATRIAL FIBRILLATION FOLLWING AN ELECTRICAL CARDIOVERSIO

Phase 1

Conditions: ON-PERMANENT ATRIAL FIBRILLATION
MedDRA version: 14.1Level: PTClassification code 10003658Term: Atrial fibrillationSystem Organ Class: 10007541 - Cardiac disorders
Therapeutic area: Diseases [C] - Cardiovascular Diseases [C14]

Registration Number: EUCTR2011-002789-18-GB

Lead Sponsor: Menarini Ricerche S.p.A

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: ot Recruiting

Sex: All

Target Recruitment: 240

Inclusion Criteria

1. Male or female patients 18 years and older;
2. Patients with persistent AF suitable for electrical direct current
cardioversion (DCC);
NOTE: According to the ESC classification, persistent AF is defined as a
continuous AF with a minimum duration of 7 days or requiring
termination by cardioversion. Prior to randomisation, successful
electrical cardioversion and maintenance of sinus rhythm at 2 hours
shall be documented;
3. A female of childbearing potential may be enrolled providing she:
- has a negative pregnancy test at baseline and
- is routinely using an effective method of birth control resulting in a low
failure rate (e.g.. hormonal contraception, intrauterine device, condoms
in combination with a spermicidal cream, total sexual abstinence orsterilisation) until end of study which corresponds to the follow-up
safety call, 2 weeks after end of treatment;
4. Able to give written informed consent before any study related
procedure;
5. Able to attend all the visits scheduled in the study.
Are the trial subjects under 18? no
Number of subjects for this age range: 0
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 240
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 240

Exclusion Criteria

1. Patients with first diagnosed AF (namely first onset of AF irrespective
of duration of arrhythmia or presence and severity of AF related
symptoms) or patients with paroxysmal AF (namely self-terminating AF
usually within 48 hours although it may continue for up to 7 days);
2. Patients with long-standing persistent AF (for this protocol defined as
AF longer than 6 months) or permanent AF (i.e. AF accepted by the
patient and by the physician);
3. Patients having known concurrent temporary secondary causes of AF
such as alcohol intoxication, pulmonary embolism, hyperthyroidism,
pneumonia, hypoxemia, acute pericarditis or myocarditis;
4. Patients having undergone atrial catheter ablation for AF;
5. Patients carrying a pacemaker;
6. Patients with electrolytes imbalances that may cause cardiac
arrhythmias, e.g. potassium < 3.5 mmol/L or > 5.5 mmol/L;
7. Patients with severe renal impairment (creatinine clearance < 30
ml/min);
8. Patients with ALT or AST > 2.5x upper limits of normal at screening or
severe hepatic impairment of any kind;
9. Patients taking potent CYP3A4 inhibitors (e.g. Itraconazole,
Ketoconazole, Voriconazol, Posaconazol, HIV protease inhibitors,
Clarithromycin, Telithromycin, Nefazodone);
10. Patients taking CYP3A4 inducers (e.g. Rifampicin, Phenytoin,
Phenobarbital, Carbamazepine, St. John's Wort);
11. Patients taking class I or Class III antiarrhythmic agents within 3
days of planned randomisation. NOTE: intravenous flecainide or
propafenone are allowed up to 72 hours and 24 hours from the planned
randomisation, respectively;
12. Patients taking beta-blockers unless used on stable doses for at least
2 weeks prior to the planned randomisation;
13. Patients taking Dronedarone or oral Amiodarone within 2 weeks and
3 months of planned randomisation, respectively. NOTE: Intravenous
administration of Amiodarone is prohibited within 72 hours from planned
randomisation;
14. Patients with a history of ECG abnormalities that in the opinion of the
Investigator render the subject unsuitable for the trial, including history
of congenital or a family history of long QT syndrome and a QTc interval
=500 msec at Screening;
15. Patients with congestive heart failure NYHA grade III and IV;
16. Patients known to be hypersensitive to Ranolazine or to any of the
components of the formulation;
17. Pregnant or breast feeding women;
18. Patients with any serious intercurrent illness (including psychiatric
and neurological disorders) which, in the opinion of the Investigator, is
incompatible with the protocol;
19. Abuse of alcohol (>350 g ethanol/week), analgesics, or psychotropic
drugs;
20. Patients concurrently participating in another study, or who have
received an investigational drug within 30 days prior to screening;
21. Patients unable to communicate well with the Investigator and to
comply with the requirements of the entire study.

Study & Design

Study Type: Interventional clinical trial of medicinal product

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Main Objective: To assess the efficacy of Ranolazine administered as 3 different dose regimens (375, 500, 750 MG BID) versus placebo in the maintenance of sinus rhythm after electrical cardioversion in patients with non-permanent AF (defined as a continuous AF with a minimum duration of 7 days to a maximum of 6 months or requiring termination by cardioversion)<br><br><br>;Secondary Objective: - To evaluate the dose-effect relationship of Ranolazine to support the<br>choice of the dose to be studied in a subsequent phase III study.<br>- To assess the safety of Ranolazine versus placebo after electrical<br>cardioversion in patients with non permanent AF.;Primary end point(s): - Time (median [days]) from randomisation to the first documented AF recurrence. Documented recurrence is defined as AF detected on TTECGs by the Core Central Lab or on 12-Lead ECGs performed during a study visit (scheduled or unscheduled).;Timepoint(s) of evaluation of this end point: Max evaluation period of 4 months (112 days).

Secondary Outcome Measures

Name	Time	Method
Secondary end point(s): - Time (median [days]) from randomisation to first documented and<br>confirmed AF recurrence. Confirmed AF recurrence is defined as a<br>documented AF which is confirmed by a consecutive ECG performed at<br>least 1 hour after its first documentation.<br>- Time (median [days]) from randomisation to first documented AF<br>recurrence in the subpopulation of patients who are still in sinus rhythm<br>2 days after the electrical cardioversion.<br>- Dose-effect relationship comparing the time (median, days) from<br>randomisation to first documented AF recurrence between Ranolazine<br>doses.;Timepoint(s) of evaluation of this end point: Max evaluation period of 4 months (112 days).

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