E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
A clinical syndrome in which impaired myocardial contractile function leads to dyspnea or exertional limitations that impair a patient’s ability to perform activities of daily life. |
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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 | 20.0 |
E.1.2 | Level | HLGT |
E.1.2 | Classification code | 10019280 |
E.1.2 | Term | Heart failures |
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 |
To compare the effect of ponsegromab versus placebo, on HF disease-specific health status in participants with HF. |
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E.2.2 | Secondary objectives of the trial |
Main Cohort: - To compare the effect of ponsegromab versus placebo on HF disease-specific overall health status in participants with HF. - To compare the effect of ponsegromab versus placebo on HF disease-specific health status in participants with HF. - To compare the effect of ponsegromab versus placebo on the physical function of participants with HF. - To compare the effect of ponsegromab versus placebo on fatigue reported by participants with HF. - To describe the safety and tolerability of ponsegromab in participants with HF. Open-Label PK Cohort: -To evaluate the safety and tolerability of ponsegromab in participants with HF and elevated circulating GDF-15 concentrations. Open-label, PK Cohort: At certain sites in the US and Canada, where permitted, participants who fail to qualify for the main cohort may be eligible for participation in a separate open-label, PK cohort.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Age and Sex: 1. Participants aged 18 years or older (or the minimum age of consent in accordance with local regulations) at screening. a. A female participant is eligible to participate if she is not pregnant or breastfeeding. b. To refer to Appendix 4 of Protocol for reproductive criteria for male (Section 10.4.1 of Protocol) and female (Section 10.4.2 of Protocol) participants. Disease Characteristics: 2. Clinical evidence of HF with each of the following criteria: a. LVEF <50% on most recent measurement, within 12 months of screening. Note: An assessment of LVEF in the prior 12 months is not required in situations where LVEF has been persistently <50% on prior assessments obtained at least 3 months apart (including the most recent measurement). b. NYHA class II-IV at screening. c. Main cohort only:NT-proBNP ≥400 pg/mL at screening. 3. Serum GDF-15 concentration ≥2000 pg/mL at screening. 4. Main cohort only: KCCQ-23 CSS <75 at screening. 5. Main cohort only: Evidence of cachexia or fatigue or functional impairment, as demonstrated by at least one of the following at screening: a. Non-edematous unintentional weight loss ≥5% in the last 6 months or current BMI <20 kg/m2, associated with subjective fatigue or anorexia; or b. Fatigue at least 3 times per week AND at least moderately bothersome fatigue in the past 2 weeks based on the KCCQ-23 administered at screening; or c. A score of <60 on the Physical Limitations Domain of the KCCQ-23 administered at screening. 6. Participants who are willing and able to comply with all scheduled visits, treatment plan, laboratory tests, lifestyle considerations, and other study procedures (including but not limited to subcutaneous injection of study intervention). |
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E.4 | Principal exclusion criteria |
Medical Conditions: 1. Acute decompensated HF within 1 month prior to SV1 or during the screening period. 2. Implantation of a cardiac resynchronization therapy device or valve repair or replacement within 3 months prior to randomization or intent to do so during the trial. * For the open-label, PK cohort only: implantation of a cardiac resynchronization therapy device more than 1 month prior to randomization is permitted. 3. History of heart transplantation, currently listed for heart transplant, current/planned mechanical circulatory support, or current/planned use of intravenous inotropes (eg, dobutamine, milrinone). 4. Acute coronary syndrome within 1 month prior to randomization. 5. Coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting) within 3 months prior to randomization or intent to undergo coronary revascularization during the trial. • For the open-label, PK cohort only: coronary revascularization more than 1 month prior to randomization is permitted. 6. Untreated indication for an implantable cardiac defibrillator or pacemaker to treat a cardiac rhythm abnormality (i.e, tachyarrhythmia or bradyarrhythmia). 7. History of allergic or anaphylactic reaction to any therapeutic or diagnostic monoclonal antibody (IgG protein) or molecules made of components of monoclonal antibody. 8. Other medical (eg, severe, uncorrected aortic stenosis; active malignancy) or psychiatric condition including recent (within the past year) or active suicidal ideation/behaviour or laboratory abnormality that may increase the risk of study participation or, in the investigator’s judgment, may limit life expectancy to less than 1 year and / or make the participant inappropriate for the study. 9. Current use of any prohibited concomitant medication(s). To refer to Section 6.9 of Protocol. 10. Previous administration with an investigational drug within 30 days (or as determined by the local requirement) or 5 half lives preceding the first dose of study intervention used in this study (whichever is longer). Treatment with an investigational biotherapeutic agent within 6 months or 5 half-lives (whichever is longer) of Day 1. 11. Previous exposure to ponsegromab in a prior clinical study. 12. Renal disease requiring ongoing dialysis. 13. Cirrhosis with evidence of portal hypertension not due to HF or the following LFT abnormalities at the time of screening, confirmed by a repeat test if deemed necessary: AST or ALT Level = 3 x ULN, or total bilirubin level = 2 x ULN (unless history of Gilbert's syndrome). 14. Investigator site staff or Pfizer employees directly involved in the conduct of the study, site staff otherwise supervised by the investigator, and their respective family members. 15.Open-label, PK Cohort: At certain sites in the US and Canada, where permitted, participants who fail to qualify for the main cohort may be eligible for participation in a separate open-label, PK cohort. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change from baseline in KCCQ-23 CSS at Week 22. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
For objective "To compare the effect of ponsegromab versus placebo on HF disease-specific overall health status in participants with HF": Change from baseline in KCCQ-23 OSS, TSS, and physical limitation at Week 22. For objective "To compare the effect of ponsegromab versus placebo on HF disease-specific health status in participants with HF": Responses as defined by a ≥5-point increase from baseline in KCCQ-23 CSS, OSS, TSS, and physical limitation at Week 22. For objective "To compare the effect of ponsegromab versus placebo on the physical function of participants with HF": Change from baseline in 6MWD at Week 22. For objective "To compare the effect of ponsegromab versus placebo on fatigue reported by participants with HF": Change from baseline in PROMIS Fatigue 7a at Week 22. For objective "To describe the safety and tolerability of ponsegromab in participants with HF": Incidence of TEAEs, TESAEs, abnormal laboratory results, and vital signs. For PK Open-Label PK Cohort secondary Objective "Incidence of TEAEs, TESAEs, abnormal laboratory results, and vital signs." Open-label, PK Cohort: At certain sites in the US and Canada, where permitted, participants who fail to qualify for the main cohort may be eligible for participation in a separate open-label, PK cohort. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Week 22 for all Main Cohort secondary endpoint except for the last one (To describe the safety and tolerability of ponsegromab in participants with HF) which will be evaluated throughout the trial as applicable. For Open-Label PK Cohort: throughout the trial. |
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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 | Yes |
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 | No |
E.6.10 | Pharmacogenetic | Yes |
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 | 4 |
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 | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 38 |
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 |
Australia |
Canada |
China |
Czechia |
Germany |
Hungary |
Japan |
Poland |
Spain |
United Kingdom |
United States |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | 2 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
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 | 22 |