E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10008908 |
E.1.2 | Term | Chronic heart failure |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary efficacy objective of the study is to compare the effects of a pulsed application of Levosimendan versus placebo of the composite end-point functional capacity and quality of life. |
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E.2.2 | Secondary objectives of the trial |
The secondary efficacy obejctives are to determine the effects of a pulsed application of levosimendan on short-term (8 weeks from randomization) and long-term (24weeks from randomisation) event-free survival (cardiac death or cardiac related hospitalization. The tertiary efficacy objective is to determine theeffect of a pulsed application of levosimendan on: a) marker of inflammatory activation (IL-6, IL-10 and TNF-alpha) b) markers of the apaptotic process (Afas, SFAS, Ligand), c) markers of oxidative stress (MDA, protein carbonyls, nitrotyrosine) d) markers of disease severity (NT-pro-BNP) e) weight f) dose of diuretics g) creatinine clearance and h) cost effectiveness |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
MRI Sub-study:
Aim of the substudy:
- Proof evidence for reverse remodeling and improvement of left ventricular function by Levosimendan, - Assessment of hibernating myocardium activated by Levosimendan.
Economic Valuation Sub Study:
Aim of the study:
- To determine the cost-effectiveness of pulsed infusion of Levosimendan in outpatients with advanced heart failure.
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E.3 | Principal inclusion criteria |
- Patients with chronic stable heart failure NYHA III and IV diagnosed at least 3 months before inclusion - 6-min.-walk-test < 350 meters - EF < 35 % - age > 20 years - optimized and individualised neurohormonal background therapy according to ESC-guidelines for the treatment of chronic heart failure. - Patient has signed informed consent
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E.4 | Principal exclusion criteria |
→ Hospitalization for decompensated heart failure requiring i.v. diuretics within the last month before randomization → History of torsades des pointes → Allergy to Levosimendan or any of the excipients → Administration of inotropes in the last 4 weeks → Potassium < 3,5 and >5,5 mmol/l → Systolic blood pressure <= 100 mmHg → Women at childbearing age without using effective contraceptives ( oral contraceptives, intrauterine contraceptive devices) unless surgical sterilisation has been undertaken. → Female patients who are pregnant or nursing → Creatinin Clearance < 30ml/min/m2 → Severe anemia (Hb < 10 mg /dl) → Mechanical obstruction affecting the ventricular filling or the outflow or both → Patients with non compliance → Severe conditions, which make the patient unsuitable to participate in a study as judged by the investigator → Severe liver disease → Percutaneous coronary intervention within the last 1 months → Coronary bypass surgery within the last 3 months → Planned HTX within the next six months → Patient involved in another clinical trial → De-nove heart failure
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E.5 End points |
E.5.1 | Primary end point(s) |
Proporation of patients showing an improvement in the six-minutes walk-testof 20 % or more and 15 % or higher scoring in the Kansas City Cardiomyopathy Questionnaire (KCCQ) at the end of the 28 week study period. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 11 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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End of the Trial = Last Patient - Last Visit |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |