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    Clinical Trial Results:
    EFFECT OF BROMOCRIPTINE ON LEFT VENTRICULAR FUNCTION IN WOMEN WITH PERIPARTUM CARDIOMYOPATHY

    Summary
    EudraCT number
    2007-003710-34
    Trial protocol
    DE  
    Global end of trial date
    04 Mar 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    04 Jan 2024
    First version publication date
    04 Jan 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    PPCM
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00998556
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Hannover Medical School
    Sponsor organisation address
    Carl-Neuberg-Str. 1, Hannover, Germany, 30625
    Public contact
    Zentrum für Klinische Studien, Hannover Medical School, EudraCT@mh-hannover.de
    Scientific contact
    Zentrum für Klinische Studien, Hannover Medical School, EudraCT@mh-hannover.de
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    13 Feb 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    04 Mar 2016
    Global end of trial reached?
    Yes
    Global end of trial date
    04 Mar 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the efficacy and safety of bromocriptine for improvement of the left ventricular function in women with peripartum cardiomyopathy (PPCM).
    Protection of trial subjects
    The clinical trial was conducted in accordance with the ethical principles that have their origins in the Declaration of Helsinki and with the standards of International Conference on Harmonisation (ICH) Good Clinical Practice (GCP).
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    30 Jun 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 63
    Worldwide total number of subjects
    63
    EEA total number of subjects
    63
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    63
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Female subjects in the first 5 months postpartum with new onset of left ventricular (LV) dysfunction (LV ejection fraction ≤35% as assessed by echocardiography) using the internationally accepted criteria for PPCM.

    Pre-assignment
    Screening details
    Eligibility will be determined based upon the inclusion and exclusion criteria.

    Period 1
    Period 1 title
    overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    not applicable

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Long-term intervention
    Arm description
    The treatment group received standard heart failure therapy (ACE-inhibitors, diuretica, beta-blockers) and bromocriptine for 8 weeks (5 mg per day for the first 2 weeks, and 2.5 mg per day for the remaining 6 weeks).
    Arm type
    Experimental

    Investigational medicinal product name
    Bromocriptine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    5 mg per day for the first twwo weeks and 2.5 mg per day for the remaining 6 weeks

    Arm title
    Short-term/ control intervention
    Arm description
    The control group received standard medical therapy as per current clinical practice and bromocriptine 2.5mg/day for up to one week
    Arm type
    Active comparator

    Investigational medicinal product name
    Bromocriptine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    2.5 mg per day for one week

    Number of subjects in period 1
    Long-term intervention Short-term/ control intervention
    Started
    31
    32
    Completed
    31
    31
    Not completed
    0
    1
         Physician decision
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Long-term intervention
    Reporting group description
    The treatment group received standard heart failure therapy (ACE-inhibitors, diuretica, beta-blockers) and bromocriptine for 8 weeks (5 mg per day for the first 2 weeks, and 2.5 mg per day for the remaining 6 weeks).

    Reporting group title
    Short-term/ control intervention
    Reporting group description
    The control group received standard medical therapy as per current clinical practice and bromocriptine 2.5mg/day for up to one week

    Reporting group values
    Long-term intervention Short-term/ control intervention Total
    Number of subjects
    31 32 63
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        From 65-84 years
    0 0 0
        85 years and over
    0 0 0
        Adults (18-65)
    31 32 63
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    34 ( 4.5 ) 33.8 ( 5.8 ) -
    Gender categorical
    Units: Subjects
        Female
    31 32 63
        Male
    0 0 0
    Gravida
    number of previous pregnancies
    Units: Subjects
        1 Gravida
    10 16 26
        2 Gravida
    8 3 11
        3 Gravida
    7 7 14
        4 Gravida
    4 2 6
        5 Gravida
    2 1 3
        6 Gravida
    0 1 1
        7 Gravida
    0 2 2
    Para
    number of previous live births
    Units: Subjects
        1 Para
    12 16 28
        2 Para
    10 6 16
        3 Para
    7 6 13
        4 Para
    1 2 3
        6 Para
    1 1 2
        7 Para
    0 1 1
    NYHA class
    Units: Subjects
        NYHA 1
    1 0 1
        NYHA 2
    4 4 8
        NYHA 3
    9 10 19
        NYHA 4
    17 18 35

    End points

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    End points reporting groups
    Reporting group title
    Long-term intervention
    Reporting group description
    The treatment group received standard heart failure therapy (ACE-inhibitors, diuretica, beta-blockers) and bromocriptine for 8 weeks (5 mg per day for the first 2 weeks, and 2.5 mg per day for the remaining 6 weeks).

    Reporting group title
    Short-term/ control intervention
    Reporting group description
    The control group received standard medical therapy as per current clinical practice and bromocriptine 2.5mg/day for up to one week

    Primary: LVEF change [in %; 6 months FU minus BL]

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    End point title
    LVEF change [in %; 6 months FU minus BL]
    End point description
    LVEF at 6 months; pEP4(MRT/ 2x Echo/ 1xEcho&CEC decision) minus LVEF at BL; Covar. for pEP (MRT/ 2x Echo/1xEcho&CEC decision)
    End point type
    Primary
    End point timeframe
    6 months follow up
    End point values
    Long-term intervention Short-term/ control intervention
    Number of subjects analysed
    28
    23
    Units: LVEF
        arithmetic mean (standard deviation)
    24.1 ( 11.3 )
    21.2 ( 10.5 )
    Statistical analysis title
    Confirmatory analysis
    Comparison groups
    Long-term intervention v Short-term/ control intervention
    Number of subjects included in analysis
    51
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.381
    Method
    confirmatory analysis
    Confidence interval

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    AE and SAE were documented up to one month after end of treatment
    Adverse event reporting additional description
    Only number of affected subjects available, not number of events.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20.0
    Reporting groups
    Reporting group title
    long-term group
    Reporting group description
    -

    Reporting group title
    short-term group
    Reporting group description
    -

    Serious adverse events
    long-term group short-term group
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 31 (0.00%)
    4 / 32 (12.50%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Vascular disorders
    Embolism
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peripheral artery occlusion
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Coronary artery occlusion
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Musculoskeletal chest pain
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    long-term group short-term group
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    12 / 31 (38.71%)
    16 / 32 (50.00%)
    Vascular disorders
    Arterial occlusive disease
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Coronary artery occlusion
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Embolism
         subjects affected / exposed
    0 / 31 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Extravasation
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Peripheral artery occlusion
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Surgical and medical procedures
    Appendicectomy
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Pregnancy, puerperium and perinatal conditions
    Lactation puerperal increased
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 32 (3.13%)
         occurrences all number
    1
    1
    General disorders and administration site conditions
    Dizziness
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 32 (3.13%)
         occurrences all number
    1
    1
    Dysgeusia
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    General physical health deterioration
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Headache
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Impaired healing
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Nasopharyngitis
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Nausea
         subjects affected / exposed
    3 / 31 (9.68%)
    0 / 32 (0.00%)
         occurrences all number
    3
    0
    Presyncope
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Vomiting
         subjects affected / exposed
    0 / 31 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    2 / 31 (6.45%)
    2 / 32 (6.25%)
         occurrences all number
    2
    2
    Cyanosis
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Dyspnoea
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Pneumonia
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Psychiatric disorders
    Acute stress disorder
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Injury, poisoning and procedural complications
    Hand fracture
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Limb injury
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 32 (3.13%)
         occurrences all number
    1
    1
    Cardiac ventricular thrombosis
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Chest pain
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Hypertension
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Hypotension
         subjects affected / exposed
    1 / 31 (3.23%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    Oedema peripheral
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Sinus bradycardia
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Ventricular fibrillation
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Ventricular tachycardia
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Blood and lymphatic system disorders
    Haemoglobin decreased
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Iron deficiency
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Iron deficiency anaemia
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 32 (3.13%)
         occurrences all number
    1
    1
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    1 / 31 (3.23%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    Gastrointestinal disorders
    Abdominal discomfort
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Abdominal pain upper
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Diarrhoea
         subjects affected / exposed
    0 / 31 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Gastroenteritis
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Gastrointestinal infection
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Hepatobiliary disorders
    Cholelithiasis
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    2 / 31 (6.45%)
    0 / 32 (0.00%)
         occurrences all number
    2
    0
    dry skin
         subjects affected / exposed
    2 / 31 (6.45%)
    0 / 32 (0.00%)
         occurrences all number
    2
    0
    Pruritus
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Rash
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Renal and urinary disorders
    Pollakiuria
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Urinary tract infection
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Endocrine disorders
    Diabetes mellitus
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Hypercalcaemia
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Musculoskeletal and connective tissue disorders
    Asthenia
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Muscle tightness
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Musculoskeletal chest pain
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 32 (3.13%)
         occurrences all number
    0
    1
    Metabolism and nutrition disorders
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0
    Blood urea increased
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 32 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    16 Feb 2010
    Amendment No.1 including but not limited to Change of coordinating investigator, change of exclusion criteria, change of sample size (50 to 60), six further trial sites
    12 Jul 2011
    Amendment No.2 including but not limited to new coordinating Investigator and principal investigator, Time frame for completion of the baseline MRI examination, Addition of the questionnaire for quality of life at visit 5, Clarification of the procedure in case that an MRI is not possible in a patient at baseline and 6 months follow up, Reporting of SAEs directly to the ZKS Leipzig, Bromocriptine will be given to all patients of the control group for 7 days 2.5 mg/day, Stratification determined by LVEF determined by MRI at baseline is not correct and is replaced by ECHO at baseline
    12 Sep 2012
    Amendment No.3 including but not limited to addition of an observation phase, clarification of therapy, tolerated deviations from planned visits
    28 Feb 2014
    Amendment No.4

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/26026286
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