E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
symptomatic hypertrophic cardiomyopathy (SHCM) |
Cardiomiopatía sintomática hipertrófica |
|
E.1.1.1 | Medical condition in easily understood language |
heart disease |
Enfermedad cardiaca |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Cardiovascular Diseases [C14] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10020871 |
E.1.2 | Term | Hypertrophic cardiomyopathy |
E.1.2 | System Organ Class | 10007541 - Cardiac disorders |
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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 study objective will be to demonstrate the efficacy of ranolazine in improving the Exercise capacity in patients affected by SHCM using the V02 peak technique |
El objetivo principal de este estudio será demostrar la eficacia de ranolazina en la mejoría de la capacidad de esfuerzo en pacientes afectados por MCHS utilizando la técnica del VO2 máximo. |
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E.2.2 | Secondary objectives of the trial |
Secondary objectives will be to demonstrate the efficacy of ranolazine on diastolic function, symptomatic status and natriuretic peptide biomarker proBNP in patients affected by SHCM. The assessment of safety by evaluation of adverse events, laboratory findings, the rest standard 12-lead ECG, detection of 24-hour arrhythmic burden by Holter ECG monitoring and physical examination will also be considered a secondary study objectives. |
Los objetivos secundarios serán demostrar la eficacia de ranolazina en la función diastólica, el estado sintomático y el biomarcador péptido natriurético proBNP en pacientes con MCHS. La evaluación de la seguridad mediante la valoración de los acontecimientos adversos, los resultados analíticos, el ECG de 12 derivaciones estándar en reposo, la detección de la carga arrítmica en 24 horas mediante registro ECG Holter y la exploración física también se considerarán objetivos secundarios del estudio. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
? Male and female gender; ? Females of childbearing potential or within two years from the menopause must have a negative urine pregnancy test (females of childbearing potential must be using adequate contraceptive precautions such as implants, injectables, combined oral contraceptives, intrauterine devices, sexual abstinence or vasectomised partner); ? Patients which fulfil conventional echocardiographic criteria for the diagnosis of SHCM: Maximum LV wall thickness >= 1.5 cm; ? Patients aged > 18 years; ? Patients with exertion symptoms and functional limitation (angina and or HF NYHA II-III); ? Presence of sinus rhythm; ? Peak V02 < 75% of predicted for age and gender; ? Absence of resting LV outflow tract obstruction (peak gradient < 30 mmHg); ? Written informed consent prior to enrolment into the study. |
? Pacientes de ambos sexos; ? Las mujeres en edad fértil o en los dos años siguientes de la menopausia deben tener un resultado negativo en la prueba de embarazo en orina (las mujeres en edad fértil deben estar usando métodos anticonceptivos eficaces, como implantes, anticonceptivos inyectables u orales combinados, dispositivos intrauterinos, abstinencia sexual o pareja con vasectomía); ? Pacientes que cumplan los criterios ecocardiográficos convencionales para el diagnóstico de MCHS: Grosor parietal máximo del VI ? 1,5 cm; ? Pacientes > 18 años de edad; ? Pacientes con síntomas y limitación funcional durante la prueba de esfuerzo (angina o IC grado II-III de la NYHA) ? Presencia de ritmo sinusal; ? VO2 máximo < 75% del valor predicho para la edad y sexo; ? Ausencia de obstrucción en el tracto de salida del VI en reposo (gradiente máximo < 30 mmHg); ? Consentimiento informado por escrito antes de la inclusión en el estudio. |
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E.4 | Principal exclusion criteria |
? Females of childbearing potential not using adequate contraceptive precautions; ? Females who are pregnant or lactating; ? Presence of known coronary artery disease (CAD); ? Presence of Chronic Obstructive Airways Disease; ? Concomitant administration of potent CYP3A4 inhibitors ? Concomitant administration of dronedarone Class Ia (e.g. quinidine) or Class III (e.g. sotalol) antiarrhythmics other than amiodarone, or other QT-prolonging drugs; ? Patients with QTc at baseline >= 500 ms; ? Any clinically relevant haematological or biochemical abnormality on routine screening, according to Investigator?s judgment; ? Severe concurrent pathology, including terminal illness (cancer, AIDS, etc.); ? Severe renal impairment defined as GFR < 29 mL/min; creatinine level > 2.5 mg/dL; BUN >60 mg/dL; ? Moderate or severe hepatic impairment or hepatic insufficiency defined as SGOT or SGPT > 2 times greater than normal upper limit or total serum bilirubin > 1.5 times greater than normal upper limit; ? Dementia, psychosis, alcoholism (>350 g ethanol/week) or chronic abuse of medicines, drugs or psychoactive substances; ? Conditions which in the Investigator?s opinion may interfere with the study?s execution or due to which the patient should not participate for safety reasons; ? Risk of low patient cooperation; ? Inability or unwillingness to issue the informed consent; ? Inability to perform a cardiopulmonary test; ? Lactose intolerance. |
? Mujeres en edad fértil que no estén utilizando métodos anticonceptivos adecuados; ? Mujeres embarazadas o lactantes; ? Diagnóstico de arteriopatía coronaria (AC) ? Presencia de enfermedad pulmonar obstructiva crónica; ? Administración concomitante de inhibidores potentes de la enzima CYP3A4 (p. ej., itraconazol, ketoconazol, voriconazol, posaconazol, inhibidores de la proteasa del VIH, claritromicina, telitromicina y nefazodona); ? Uso concomitante de dronedarona, antiarrítmicos del grupo Ia (p. ej., quinidina) o del grupo III (p. ej., dofetilida o sotalol), aparte de amiodarona, u otros fármacos que prolonguen el intervalo QTc; ? Pacientes con QTc ? 500 ms en el momento basal; ? Cualquier anomalía hematológica o bioquímica clínicamente relevante en el despistaje rutinario, según el criterio del investigador; ? Patología concurrente grave, incluida enfermedad terminal (cáncer, SIDA, etc.); ? Insuficiencia renal grave, definida como un índice de filtración glomerular < 29 ml/min; creatinina sérica > 2,5 mg/dl; urea > 60 mg/dl; ? Deterioro hepático moderado o grave o insuficiencia hepática definida por una SGOT o SGPT > 2 veces el límite superior de la normalidad o bilirrubina sérica total > 1,5 veces el límite superior de la normalidad; ? Demencia, psicosis, alcoholismo (> 350 g etanol/semana) o abuso crónico de medicamentos, drogas o sustancias psicoactivas; ? Afecciones que, en opinión del investigador, pudieran interferir con la ejecución del estudio o debido a las cuales el paciente no debería participar por motivos de seguridad; ? Riesgo de escasa colaboración por parte del paciente; ? Incapacidad o falta de disposición para otorgar su consentimiento informado; ? Incapacidad de realizar el estudio cardiopulmonar. ? Intolerancia a la lactosa |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Evaluation of Exercise Capacity with the V02 peak in patients with SHCM after 5 months of treatment with ranolazine or placebo |
Evaluación del VO2 máximo con la prueba cardiorrespiratoria, después de 5 meses recibiendo la dosis máxima alcanzada de ranolazina o placebo. |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
after 5 months |
Tras 5 meses |
|
E.5.2 | Secondary end point(s) |
E/E? ratio evaluation; Natriuretic peptides biomarkers evaluation (proBNP biomarkers); Symptomatic Status evaluation (Minnesota Living With Heart Failure Questionnaire) |
? Evaluación del cociente E/E? con la técnica DT ? Evaluación del biomarcador péptido natriurético mediante el proBNP ? Evaluación del estado sintomático con el cuestionario MLWHFQ (Minnesota Living With Heart Failure Questionnaire). |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
after 1 and 5 months |
Tras 1 y 5 meses |
|
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 | Yes |
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) | 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.8.2.4 | Number of treatment arms in the trial | 2 |
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 | No |
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
|
LPLV |
último visita del último paciente |
|
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 | 11 |
E.8.9.1 | In the Member State concerned days | 14 |
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 | 11 |
E.8.9.2 | In all countries concerned by the trial days | 14 |