E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Systolic heart failure |
Systolic heart failure |
|
E.1.1.1 | Medical condition in easily understood language |
Systolic heart failure |
Systolic heart failure |
|
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 | 14.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10019279 |
E.1.2 | Term | Heart failure |
E.1.2 | System Organ Class | 100000004849 |
|
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 objective is to assess if the study drug - Mirabegron - improves myocardial pump function in patients with heart failure
Primary endpoint
Increase in LVEF (measured by MRI or CT)
|
The objective is to assess if the study drug - Mirabegron - improves myocardial pump function in patients with heart failure
Primary endpoint
Increase in LVEF (measured by MRI or CT)
|
|
E.2.2 | Secondary objectives of the trial |
Secondary endpoints
Combined endpoints including;
1) A reduction in NT proBNP,
2) An increase in 6 min walking distance,
3) An increase in CO/SV,
4) A reduction in LVIDd,
5) An improvement in diastolic function,
6) A reduction in LA volume,
7) An increase in LVEF,
8) A shortening of the QT interval
9) Improvement in quality of life
10) Improvement in functional class
|
Secondary endpoints
Combined endpoints including;
1) A reduction in NT proBNP,
2) An increase in 6 min walking distance,
3) An increase in CO/SV,
4) A reduction in LVIDd,
5) An improvement in diastolic function,
6) A reduction in LA volume,
7) An increase in LVEF,
8) A shortening of the QT interval
9) Improvement in quality of life
10) Improvement in functional class
|
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Inclusion criteria
1. Stable heart failure NYHA class II-III on ischemic or non-ischemic basis
2. Left ventricular ejection fraction (LVEF) < 40%
3. Stable sinus rhythm (SR)
4. On optimised evidence-based pharmacological HF treatment stable > 4 weeks with no current plan for changing HF therapy. The therapy must include a beta-blocker.
5. No change in diuretics < 4 weeks
6. >18 years
|
Inclusion criteria
1. Stable heart failure NYHA class II-III on ischemic or non-ischemic basis
2. Left ventricular ejection fraction (LVEF) < 40%
3. Stable sinus rhythm (SR)
4. On optimised evidence-based pharmacological HF treatment stable > 4 weeks with no current plan for changing HF therapy. The therapy must include a beta-blocker.
5. No change in diuretics < 4 weeks
6. >18 years
|
|
E.4 | Principal exclusion criteria |
Exclusion criteria
1. Unstable cardiac condition
2. Acute myocardial infarction (AMI) or revascularisation < 3 month ago
3. Atrial fibrillation (for technical reasons in relation to imaging and HR reporting)
4. Uncorrected significant primary obstructive valve disease
5. Planned major surgery including cardiac revascularisation
6. Hemodynamically significant obstructive cardiomyopathy
7. Stroke with significant neurological deficit
8. Acute myocarditis or constrictive pericarditis
9. Symptomatic bradycardia or > 1. degree AV-block unless the patient has a pacemaker
10. Clinically significant hepatic (transaminases or bilirubin x 3 above upper reference level) or renal (GFR< 50 ml/min/1,73 m2) diseases
11. Heart failure due to uncorrected thyroid disease
12. Cardiac mechanical support
13. < 6 months after CRT
14. Uncontrolled hypotension (defined as symptomatic systolic blood pressure < 90 mmHg) - or hypertension (defined as systolic at 180 mmHg or above and/or diastolic blood pressure at 110 mmHg or below)
15. Body mass index (BMI) > 35
16. Unable to give informed consent
17. Reduced compliance
18. All women of child bearing potential will be required to use adequate contraception
19. Pregnant or lactating women
20. Treatment with a tricyclic antidepressant or CYP2D6 substrates other than beta-blockers or treatment with dig
|
Exclusion criteria
1. Unstable cardiac condition
2. Acute myocardial infarction (AMI) or revascularisation < 3 month ago
3. Atrial fibrillation (for technical reasons in relation to imaging and HR reporting)
4. Uncorrected significant primary obstructive valve disease
5. Planned major surgery including cardiac revascularisation
6. Hemodynamically significant obstructive cardiomyopathy
7. Stroke with significant neurological deficit
8. Acute myocarditis or constrictive pericarditis
9. Symptomatic bradycardia or > 1. degree AV-block unless the patient has a pacemaker
10. Clinically significant hepatic (transaminases or bilirubin x 3 above upper reference level) or renal (GFR< 50 ml/min/1,73 m2) diseases
11. Heart failure due to uncorrected thyroid disease
12. Cardiac mechanical support
13. < 6 months after CRT
14. Uncontrolled hypotension (defined as symptomatic systolic blood pressure < 90 mmHg) - or hypertension (defined as systolic at 180 mmHg or above and/or diastolic blood pressure at 110 mmHg or below)
15. Body mass index (BMI) > 35
16. Unable to give informed consent
17. Reduced compliance
18. All women of child bearing potential will be required to use adequate contraception
19. Pregnant or lactating women
20. Treatment with a tricyclic antidepressant or CYP2D6 substrates other than beta-blockers or treatment with dig
|
|
E.5 End points |
E.5.1 | Primary end point(s) |
Primary endpoint
Increase in LVEF (measured by MRI or CT)
|
Primary endpoint
Increase in LVEF (measured by MRI or CT)
|
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
After 26 weeks treatment |
After 26 weeks treatment |
|
E.5.2 | Secondary end point(s) |
Secondary endpoints
Combined endpoints including;
1) A reduction in NT proBNP,
2) An increase in 6 min walking distance,
3) An increase in CO/SV,
4) A reduction in LVIDd,
5) An improvement in diastolic function,
6) A reduction in LA volume,
7) An increase in LVEF,
8) A shortening of the QT interval
9) Improvement in quality of life
10) Improvement in functional class
|
Secondary endpoints
Combined endpoints including;
1) A reduction in NT proBNP,
2) An increase in 6 min walking distance,
3) An increase in CO/SV,
4) A reduction in LVIDd,
5) An improvement in diastolic function,
6) A reduction in LA volume,
7) An increase in LVEF,
8) A shortening of the QT interval
9) Improvement in quality of life
10) Improvement in functional class
|
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
After 26 weeks treatment |
After 26 weeks treatment |
|
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 | No |
E.6.5 | Efficacy | No |
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 | 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.8.2.4 | 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 | 2 |
E.8.5 | The trial involves multiple Member States | No |
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 | No |
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 |
|
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
|
The trial ends with the last visit of the last included patient or prematurely if definitions for early treatment as stated in the protocol are reached. |
The trial ends with the last visit of the last included patient or prematurely if definitions for early treatment as stated in the protocol are reached. |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |