A Study of Mavacamten in Participants With HFpEF and Chronic Elevation of cTnI and/or NT-proBNP

• Status: Recruiting
• Trial end date: 2022-05-01
• Target enrollment: 0
• Participant gender: All

Summary

This is a Phase 2a proof-of-concept study to assess safety, tolerability, and preliminary efficacy of mavacamten treatment on biomarkers levels in participants with heart failure with preserved ejection fraction (HFpEF) and chronic elevation of cTnI and/or NT-proBNP. Data from this study will inform future study designs of mavacamten in participants with HFpEF.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: MyoKardia, Inc.

Criteria

Key Inclusion Criteria:

1. Is at least 50 years old at Screening.

2. Body weight is greater than 45 kg at Screening.

3. Documented prior objective evidence of heart failure as shown by 1 or more of the following criteria:

• Previous hospitalization for heart failure with documented radiographic evidence of pulmonary congestion.

• Elevated LV end-diastolic pressure or pulmonary capillary wedge pressure at rest (≥15 mm Hg) or with exercise (≥25 mm Hg).

• Elevated level of NT-proBNP (>400 pg/mL) or brain natriuretic peptide (BNP) (>200 pg/mL).

• Echocardiographic evidence of medial E/e' ratio ≥ 15 or left atrial enlargement (left atrial volume index >34 mL/m2) together with chronic treatment with spironolactone, eplerenone, or a loop diuretic.

4. Meets 1 or more of the following criteria:

• A hs-cTnI >99th percentile at screening OR

• NT-proBNP* >300 pg/mL at initial screening measurement (if not in atrial fibrillation or atrial flutter) or >750 pg/mL (if in atrial fibrillation or atrial flutter). OR

• If the screened participant is either of African descent or has a body mass index ≥30.0 kg/m2, a screening NT-proBNP* >240 pg/mL (if not in atrial fibrillation or atrial flutter) or >600 pg/mL (if in atrial fibrillation or atrial flutter).

5. Has documented LVEF ≥60% at the Screening visit and no history of prior LVEF ≤ 45%

6. Has documented elevated left ventricular mass index (LVMI) by 2-dimensional imaging (>95 g/m2 if female and >115 g/m2 if male) OR maximal left ventricular wall thickness ≥12 mm.

7. Has adequate acoustic windows on screening resting TTE

8. Has NYHA class II or III symptoms at Screening.

Key Exclusion Criteria:

1. Has a prior diagnosis of HCM OR a known infiltrative or storage disorder causing HFpEF and/or cardiac hypertrophy, such as amyloidosis, Fabry disease, or Noonan syndrome with LV hypertrophy OR a positive serum immunofixation result.

2. Has a history of syncope within the last 6 months or sustained ventricular tachycardia with exercise within the past 6 months.

3. Has a history of resuscitated sudden cardiac arrest at any time or known appropriate implantable cardioverter defibrillator discharge within 6 months prior to Screening.

4. Has persistent or permanent atrial fibrillation not on anticoagulation for at least 4 weeks prior to Screening and/or is not adequately rate controlled within 6 months prior to Screening.

5. Currently treated or planned treatment during the study with either: (a) a combination of beta blocker and verapamil or a combination of beta blocker and diltiazem, (b) disopyramide, or (c) biotin or biotin-containing supplements/multivitamins.

6. Has known moderate or severe aortic valve stenosis, hemodynamically significant mitral stenosis, or severe mitral or tricuspid regurgitation at Screening

7. Has severe chronic obstructive pulmonary disease, or other severe pulmonary disease, requiring home oxygen, chronic nebulizer therapy, chronic oral steroid therapy or hospitalized for pulmonary decompensation within 12 months.

8. Has body mass index ≥45.0 kg/m2

9. Has left ventricular global longitudinal strain by TTE in the range from 0 to -12.0 (assessed by central TTE reader)

10. Has NT-proBNP at Screening >2000 pg/mL