E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
JNJ-39588146 is being developed for the treatment of heart failure. |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10019279 |
E.1.2 | Term | 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 |
Assess the hemodynamic effects, the safety and the tolerability of JNJ-39588146 when administered by intravenous infusion to male subjects and female subjects of non-childbearing potential with New York Heart Association (NYHA) Class II-IV heart failure. |
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E.2.2 | Secondary objectives of the trial |
Characterize the pharmacokinetics of JNJ-39588146 in subjects with heart failure. |
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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 |
Assess the hemodynamics for an 18-hour extended infusion. Assess the effect of JNJ- 39588146 on relevant cardiovascular biomarkers detected in blood sample. |
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E.3 | Principal inclusion criteria |
1. Subjects must have signed an informed consent document indicating that they understand the purpose of the study and the procedures required for the study and are willing to participate in the study.
2a. Subjects must have systolic dysfunction (LVEF ≤0.35, documented within the 6 months prior to dosing by any quantitative method) and Heart Failure (New York Heart Association [NYHA] functional class II-IV). Subjects considered by the principal investigator as having end-stage or refractory heart failure characterized by severe cachexia, restriction to bed rest, hospice status or are in imminent need (within the next 30 days) of a left ventricular assist device or heart transplant should not be considered for the study.
2b. Have a pulmonary capillary wedge pressure ≥20 mm Hg immediately prior to the initiation of the infusion (average of 3 measurements).
3. Have a cardiac index ≤2.5 L/min/m2 immediately prior to the initiation of the infusion (average of 3 measurements).
4. Subjects must have supine blood pressure (after resting for 5 min) between the range of 95 - 160 mm Hg systolic (inclusive), and 50 - 89 mm Hg diastolic (inclusive) at screening and Day 1 pre-dose.
5. Criterion modified per amendment 5.1 Must not have received intravenous heart failure medications including inotropes, vasodilators or diuretics, for at least 18 hours prior to initiation of study infusion. Subjects requiring intravenous medications to control their heart failure (such as inotropes and/or vasodilators within the next 48 hours and/or diuretics within the next 24 hours) should not participate in the study. If there is a planned elective evaluation of a subject’s cardiac response to inotropes/vasodilators, they may participate in the study if the planned elective treatment with these agents is ≥4 hours after the end of the study drug infusion.
6. Criterion modified per amendment 6.1 Serum potassium within normal limits confirmed within 2 week of the study drug infusion. If there has been a change in diuretic therapy within these past 2 weeks, serum potassium must be within normal limits within 24 hours of dosing.
7. Criterion modified per amendment 7.1 Subjects must have a body mass index (BMI) between 18 to 35 kg/m2 (inclusive) and with a minimum body weight of 50 kg.
8. Female subjects must be of non-childbearing potential, defined as either being: - postmenopausal (for at least 24 months) or, - surgically sterile for more than 6 months prior to participation in the study (have had a hysterectomy or bilateral oophorectomy, tubal ligation, or otherwise be incapable of pregnancy), and must have a negative serum ß-human chorionic gonadotropin (ß-hCG) pregnancy test at screening; and a negative urine pregnancy test on admission to the clinical study unit.
9. Male subjects must consent to utilize a medically acceptable method of contraception throughout the study and for 3 months after the last dose of study drug and to not donate sperm during the study and for 3 months after receiving the last dose of study drug. Medically acceptable methods of contraception that may be used by the subject and/or the partner include double barrier method (condom, diaphragm, or cervical cap used with intravaginal spermicidal foam, cream, or gel), IUD, surgical sterilization (6 months post surgery), post-menopausal partner (not experiencing a menstrual period for a minimum of two years) and hormonal contraceptives (which must be used consistently for 3 months prior to the initiation of the study drug infusion) such as oral contraceptives, hormonal patches, progestin implants or injections, and etonogestrel/ethinyl estradiol vaginal rings (NuvaRing®).
10. Criterion modified per amendment 10.1 Male or female subjects between 18 and 86 years of age, inclusive.
11. Willing/able to adhere to the prohibitions and restrictions specified in this protocol. |
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E.4 | Principal exclusion criteria |
1. Subjects without bundle branch block with confirmed screening QTcF interval >450 msec in males or > 470 msec in females. Subjects with bundle branch block or receiving amiodarone with confirmed screening QTcF interval >500 msec. Subjects with a history of additional risk factors for torsades de pointe (eg, hypokalemia, family history of Long QT Syndrome), or the use of concomitant medications that prolong the QT/QTc interval.
2. Subjects with atrial fibrillation, sinus tachycardia, sustained ventricular tachycardia, ventricular fibrillation within the last 30 days or third degree heart block at screening or check-in.
3. Subjects with a resting heart rate less than 50 or greater than 100 beats per minute (via ECG output pre-dose).
4. Criterion modified per amendment 4.1 Acute coronary syndrome, myocardial infarction or coronary revascularization (CABG or percutaneous coronary intervention) within 1 month or history of resuscitated sudden death or systemic shock.
5. Subjects with a left-ventricular assist device or heart transplant or mechanical ventilation.
6. Subjects with hemodynamically-significant primary valvular heart disease.
7. Subjects with serum digoxin concentrations (minimum levels) >1.5 ng/ml at screening.
8. Subjects in whom the PA catheter is being placed solely for study measurements, with an INR >1.5 when femoral, subclavian or jugular approach is used.
9. History of transient ischemic attack within the 6 months before screening.
10. History of clinically significant chronic hepatic, reproductive, gastrointestinal, primary renal, hematologic, pulmonary, neurologic, respiratory or psychiatric disorders, and oncologic conditions or acute or chronic infection.
11. Subjects with uncontrolled hypertension or/and uncontrolled diabetes.
12. Criterion modified per amendment 12.1 Subjects with ALT or AST greater than 3 times the upper limit of normal at screening may not participate in the study.
13. Subjects with creatinine clearance <30 mL/min at screening or subjects requiring dialysis or serum ultra-filtration.
14. Any condition that, in the opinion of the Investigator, would compromise the well being of the subject or the study or prevent the subject from meeting or performing study requirements.
15. Subjects for which there is a concern of right intra-ventricular lead displacement including subjects who have had placement of pacemaker or ICD within the past 3 months before screening.
16. Subjects with heart failure caused by myositis, lung disease, congenital heart disease, constrictive pericarditis, or hypertrophic or restrictive cardiomyopathy.
17. Subjects planning to parent a child during the study or within 3 months after the last dose of study drug.
18. Pregnant or breast-feeding females.
19. Employees of the Investigator or study center, with direct involvement in the proposed study or other studies under the direction of that Investigator or study center, as well as family members of the employees or the Investigator.
20. Known allergies, hypersensitivity, or intolerance to JNJ-39588146 or its excipients (refer to Section 14.1, Physical Description of Study Drug(s)), or urocortin or urocortin 2.
21. Received an investigational drug (including vaccines) or used an investigational medical device within 30 days before the planned start of treatment, or within a period of less than ten times the drug’s half-life, whichever is longer.
22. Subjects who have donated blood or plasma, or have had blood loss of more than 500 mL within 8 weeks prior to check-in, or plan to donate blood or plasma during the study.
23. Subjects with drug or alcohol abuse within the past 2 months prior to dosing or at risk of withdrawal symptoms during the study. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Two primary endpoints are the post-baseline changes (at 1-hour, 2 hours and 3 hours post infusion initiation) in pulmonary capillary wedge pressure and cardiac index. The two primary endpoints will be used separately to compare JNJ-39588146 with placebo. |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
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 | Yes |
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 | 18 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 0 |