An 18 Month Open Label Study Of The Tolerability And Efficacy Of An Antisense Oligonucleotide In Patients With Wild-Type Transthyretin Amyloid Cardiomyopathy (Senile Systemic Amyloidosis)
试验速览
- 阶段
- 2 期
- 状态
- 撤回
- 主要终点
- Systolic strain imaging by echocardiographic speckle tracking
研究概览
简要总结
ATTRwt (also known as senile systemic, or senile cardiac amyloidosis) is a progressive heart disease, causing congestive heart failure. It is caused by amyloid protein deposits in the heart, that are derived from a normal protein, TTR, made in the liver. The aim of the study is to determine whether lowering the blood levels of TTR, by a weekly injection of a compound designed specifically to do this, will slow the progression of the disease when treated patients are compared to previously-followed patients who were not receiving this drug. The study also aims to determine how well this drug is tolerated and the existence and severity of any drug side-effects.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 50 Years 至 90 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients should, in the opinion of the Investigator, be in a stable state in terms of NYHA class. Class I-III patients will be recruited.
- •Age 50-90 years
- •Male or non-pregnant, non-lactating females. If a woman is premenopausal, or a male partners with a premenopausal woman, she/he must be willing to use the following methods of contraception: condoms, oral/hormonal contraception, Intrauterine Device, diaphragm, or abstinence
- •Written informed consent to be obtained prior to study treatment
- •Histochemical diagnosis of amyloidosis as based on detection by polarizing microscopy of green birefringent material in Congo red-stained tissue specimens
- •Molecular definition of the absence of a TTR mutation or immunohistochemical staining of amyloid fibrils with anti TTR antibody and negative genetic testing for a TTR mutation.
- •Willingness to return to the treating center for follow-up.
- •Willingness and ability to self-administer, or to have spouse administer weekly subcutaneous injections of study drug.
排除标准
- •Patients who, in the opinion of the Investigator, require further adjustment of diuretics at the time of screening to achieve optimal treatment of heart failure. Once stable for 2 weeks, patients in Class I-III will become eligible for inclusion.
- •Patients with NYHA class 4 congestive heart failure.
- •Concomitant non-amyloid heart disease that might, in the opinion of the investigator, cause changes in strain imaging on serial follow-up (e.g. aortic stenosis of greater than mild severity, unstable coronary artery disease).
- •Prior liver transplantation or liver transplantation anticipated in less than 6 months;
- •ALT and/or AST ³ 2 x ULN and/or Alkaline phosphatase ³ 2 x UNL;
- •Estimated glomerular filtration rate (EGFR) < 50 ml/min;
- •Any other lab values that in the opinion of the investigator might place the subject at unacceptable risk for participation in the study;
- •History of poor compliance with medications or medical treatment, based on a review of medical records.
- •History of hypersensitivity to any of the ingredients of the study therapy;
- •Use of any investigational drug for amyloidosis within 4 weeks prior to study entry or during the study.
- •Current use of tafamidis, diflunisal, doxycycline or TUDCA for therapy of amyloidosis.
研究组 & 干预措施
Experimental Drug
Isis 420915/GSK 299872, an antisense oligonucleotide. Administered subcutaneously three times per week for the first week, and then weekly for 18 months. Each dose shall contain 300 mg of active drug.
干预措施: Isis 420915/GSK 299872 (Drug)
结局指标
主要结局
Systolic strain imaging by echocardiographic speckle tracking
时间窗: Month 12
The primary echocardiographic parameter to be measured will be longitudinal left ventricular (LV) strain (units = % LV longitudinal shortening) as compared to baseline.
次要结局
- LV cellular component as determined by cMRI (units = % of total LV mass)(18 months)
- Systolic strain evaluation by echocardiography(Secondary analysis will occur at 18 months)
- Echocardiographic determination of Mean thickness of LV septum and posterior wall (units = mm)(18 months)
- Echocardiographic determination of LV ejection fraction (units = %)(18 months)
- LV mass measurement by Cardiac MRI (cMRI) (units = grams)(Month 12)
- LV extracellular component as determined by cMRI (units = % of total LV mass)(18 months)
- Extent of cMRI late gadolinium enhancement of the LV (unites = % of area)(18 months)
研究者
Rodney H. Falk, MD
Director, Brigham and Women's Cardiac Amyloidosis Program
Brigham and Women's Hospital