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CZ696 in heart failure patients: effect on left ventricular remodeling and fibrosis assessed by novel heart failure biomarkers and cardiac magnetic resonance

Phase 1
Conditions
Chronic heart failure NYHA class II-IV with reduced ejection fraction (EF =< 40%) and elevated NT-proBNP = 600 pg/mL, but 400 pg/mL if hospitalized for heart failure within 12 months
Therapeutic area: Diseases [C] - Cardiovascular Diseases [C14]
Registration Number
EUCTR2017-002914-30-ES
Lead Sponsor
FIMABIS
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
68
Inclusion Criteria

- Patients must give written informed consent before any assessment is performed.

- Outpatients = 18 years of age, male or female.

-Diagnosis of chronic heart failure NYHA class II-IV with reduced ejection fraction (EF =< 40%) and elevated NT-proBNP = 600 pg/mL, but 400 pg/mL if hospitalized for heart failure within 12 months.

- Charlson Index = 5.

- The patients must be treated with angiotensin-converting-enzyme inhibitor (ACEI) or an angiotensin-converting-enzyme inhibitor (ARB), ß-blocker and mineralocorticoid antagonist receptor unless contraindicated or not tolerated, at a stable dose for at least 4 weeks.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 68
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 68

Exclusion Criteria

- History of hypersensitivity or allergy to any of the study drugs, drugs of similar chemical classes, ACEIs, ARBs, or neprilysin inhibitors as well as known or suspected contraindications to the study drugs.

- Previous history of intolerance to recommended target doses of ACEIs or ARBs.

- Known history of angioedema.

- Requirement of treatment with both ACEIs and ARBs

- Current acute decompensated heart failure (exacerbation of chronic heart failure manifested by signs and symptoms that may require intravenous therapy).

- Symptomatic hypotension and/or a SBP < 100 mmHg

- Estimated GFR < 30 mL/min/1.73m2 as measured by the simplified Modification of Diet in Renal Disease (MDRD) Study equation.

- Serum potassium > 5.2 mmol/L.

- Participation in clinical trial with another drug within 30 days of first study visit.

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Main Objective: - To describe the effect of LCZ696 on left ventricular remodeling and myocardial fibrosis assessed by cardiac magnetic resonance in heart failure patients with reduced ejection fraction and high comorbidity;Secondary Objective: - To describe the effect of LCZ696 on left ventricular remodeling and myocardial fibrosis assessed by novel heart failure biomarker (soluble ST2) in heart failure patients with reduced ejection fraction and high comorbidity.<br><br>- To assess correlation of novel HF Biomarker with Soc HF biomarkers.<br><br>- To describe the effect of LCZ696 on left ventricular remodeling and myocardial fibrosis assessed by variation from baseline in % of fibrosis and LV Volume;Primary end point(s): - Variation of myocardial fibrosis assessed by changes (from basal to month 12 visit) in quantification of mass of myocardial fibrosis, as identified by delayed contrast-enhancement in cardiac MRI.;Timepoint(s) of evaluation of this end point: Base line and after 12 months treatment
Secondary Outcome Measures
NameTimeMethod
Secondary end point(s): -Assessment of change from baseline in heart failure biomarkers: soluble ST2. Correlation with change in fibrosis as assessed by cardiac MRI.<br>-Assessment of change from baseline in SoC heart failure biomarkers: (N- terminal pro-B-type natriuretic peptide and highly-sensitive troponin). Correlation with change assessed with novel biomarker.<br>-Variation from baseline in percentage (%) of myocardial fibrosis and LV Volume according to total myocardium assessed by cardiac magnetic resonance.;Timepoint(s) of evaluation of this end point: First two endpoints timepoint's: Baseline, 3, 6,9 and 12 months after treatment<br>Third endpoint: Baseline and after 12 months treatment
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