Safety and Tolerability of Initiating LCZ696 in Heart Failure Patients (TITRATION)

September 16, 2015 updated by: Novartis Pharmaceuticals

A Multicenter, Randomized, Double-blind, Parallel Group Study to Assess the Safety and Tolerability of Initiating LCZ696 in Heart Failure Patients Comparing Two Titration Regimens

The purpose of this study is to assess the safety and tolerability of initiating LCZ696 in heart failure patients with reduced ejection fraction (HF-rEF) using conservative (reaching target dose over 6 weeks) and condensed (reaching target dose over 3 weeks) up-titration regimens.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
498

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Bulgaria
      • Gabrovo, Bulgaria, 5300
        • Novartis Investigative Site
      • Plovdiv, Bulgaria, 4000
        • Novartis Investigative Site
      • Plovdiv, Bulgaria, 4004
        • Novartis Investigative Site
      • Smolian, Bulgaria, 4700
        • Novartis Investigative Site
      • Sofia, Bulgaria, 1407
        • Novartis Investigative Site
      • Sofia, Bulgaria, 1202
        • Novartis Investigative Site
  • Finland
      • Jyvaskyla, Finland, 40620
        • Novartis Investigative Site
      • Tampere, Finland, 33520
        • Novartis Investigative Site
  • Germany
      • Bad Krozingen, Germany, 79189
        • Novartis Investigative Site
      • Berlin, Germany, 10367
        • Novartis Investigative Site
      • Berlin, Germany, 13353
        • Novartis Investigative Site
      • Berlin, Germany, 10787
        • Novartis Investigative Site
      • Berlin, Germany, 10789
        • Novartis Investigative Site
      • Berlin, Germany, 13347
        • Novartis Investigative Site
      • Berlin, Germany, 13405
        • Novartis Investigative Site
      • Berlin, Germany, 13055
        • Novartis Investigative Site
      • Berlin-Buch, Germany, 13125
        • Novartis Investigative Site
      • Dietzenbach, Germany, 63128
        • Novartis Investigative Site
      • Ebersbach, Germany, 02730
        • Novartis Investigative Site
      • Frankfurt, Germany, 60594
        • Novartis Investigative Site
      • Göttingen, Germany, D-37075
        • Novartis Investigative Site
      • Hassloch, Germany, 67454
        • Novartis Investigative Site
      • Huy / OT Anderbeck, Germany, 38836
        • Novartis Investigative Site
      • Ingelheim, Germany, 55218
        • Novartis Investigative Site
      • Kelkheim, Germany, 65779
        • Novartis Investigative Site
      • Kleve, Germany, 47533
        • Novartis Investigative Site
      • Leipzig, Germany, 04315
        • Novartis Investigative Site
      • Mainz, Germany, 55131
        • Novartis Investigative Site
      • Mainz, Germany, 55116
        • Novartis Investigative Site
      • Mühlheim, Germany, 45468
        • Novartis Investigative Site
      • Siegen, Germany, 57072
        • Novartis Investigative Site
      • Straubing, Germany, 94315
        • Novartis Investigative Site
      • Wuerzburg, Germany, 97078
        • Novartis Investigative Site
  • Hungary
      • Budapest, Hungary, 1145
        • Novartis Investigative Site
      • Budapest, Hungary, 1042
        • Novartis Investigative Site
      • Budapest, Hungary, H-1096
        • Novartis Investigative Site
      • Debrecen, Hungary, 4032
        • Novartis Investigative Site
      • Mosonmagyarovar, Hungary, 9200
        • Novartis Investigative Site
      • Nyiregyháza, Hungary, 4400
        • Novartis Investigative Site
      • Pecs, Hungary, 7623
        • Novartis Investigative Site
      • Szekesfehervar, Hungary, 8000
        • Novartis Investigative Site
  • Italy
    • AO
      • Aosta, AO, Italy, 11100
        • Novartis Investigative Site
    • AR
      • Cortona, AR, Italy, 52044
        • Novartis Investigative Site
    • BG
      • Bergamo, BG, Italy, 24128
        • Novartis Investigative Site
    • BO
      • Bologna, BO, Italy, 40138
        • Novartis Investigative Site
    • FE
      • Cona, FE, Italy, 44100
        • Novartis Investigative Site
    • RM
      • Albano Laziale, RM, Italy, 00041
        • Novartis Investigative Site
      • Roma, RM, Italy, 00163
        • Novartis Investigative Site
    • SS
      • Sassari, SS, Italy, 07100
        • Novartis Investigative Site
    • TV
      • Vittorio Veneto, TV, Italy, 31029
        • Novartis Investigative Site
    • UD
      • San Daniele Del Friuli, UD, Italy, 33038
        • Novartis Investigative Site
  • Puerto Rico
      • San Juan, Puerto Rico, 00936-6528
        • Novartis Investigative Site
  • Slovakia
      • Bratislava, Slovakia, 821 07
        • Novartis Investigative Site
      • Bratislava, Slovakia, 83301
        • Novartis Investigative Site
      • Kosice, Slovakia, 040 01
        • Novartis Investigative Site
      • Lucenec, Slovakia, 98439
        • Novartis Investigative Site
      • Nove Zamky, Slovakia, 940 01
        • Novartis Investigative Site
      • Trebisov, Slovakia, 075 01
        • Novartis Investigative Site
    • Slovak Republic
      • Brezno, Slovak Republic, Slovakia, 977 42
        • Novartis Investigative Site
      • Nitra, Slovak Republic, Slovakia, 949 01
        • Novartis Investigative Site
      • Svidnik, Slovak Republic, Slovakia, 08901
        • Novartis Investigative Site
  • Spain
      • Madrid, Spain, 28007
        • Novartis Investigative Site
    • Andalucia
      • Almeria, Andalucia, Spain, 04120
        • Novartis Investigative Site
      • Malaga, Andalucia, Spain, 29010
        • Novartis Investigative Site
      • Sanlucar de Barrameda, Andalucia, Spain, 11540
        • Novartis Investigative Site
      • Sevilla, Andalucia, Spain, 41014
        • Novartis Investigative Site
    • Cadiz
      • Villamartin, Cadiz, Spain, 11650
        • Novartis Investigative Site
    • Catalunya
      • Barcelona, Catalunya, Spain, 08035
        • Novartis Investigative Site
    • Galicia
      • A Coruna, Galicia, Spain, 15006
        • Novartis Investigative Site
  • Turkey
      • Haydarpasa/Istanbul, Turkey, 34668
        • Novartis Investigative Site
      • Istanbul, Turkey, 34304
        • Novartis Investigative Site
      • Kocaeli, Turkey, 41380
        • Novartis Investigative Site
      • Mersin, Turkey, 33079
        • Novartis Investigative Site
      • Sivas, Turkey, 58140
        • Novartis Investigative Site
  • United Kingdom
      • Bath, United Kingdom, BA1 3NG
        • Novartis Investigative Site
      • Bradford, United Kingdom, BD9 6RJ
        • Novartis Investigative Site
      • Coventry, United Kingdom, CV2 2DX
        • Novartis Investigative Site
      • Harrow, United Kingdom, HA1 3UJ
        • Novartis Investigative Site
      • Nuneaton, United Kingdom, CV10 7DJ
        • Novartis Investigative Site
    • Dorset
      • Dorchester, Dorset, United Kingdom, DT1 2JY
        • Novartis Investigative Site
    • East Sussex
      • St Leonards on Sea, East Sussex, United Kingdom, TN37 7RD
        • Novartis Investigative Site
    • Lancashire
      • Oldham, Lancashire, United Kingdom, OL1 2JH
        • Novartis Investigative Site
    • Tyne and Wear
      • Gateshead, Tyne and Wear, United Kingdom, NE9 6SX
        • Novartis Investigative Site
  • United States
    • Alaska
      • Anchorage, Alaska, United States, 99508
        • Novartis Investigative Site
    • Arizona
      • Gilbert, Arizona, United States, 85297
        • Novartis Investigative Site
      • Tucson, Arizona, United States, 85710
        • Novartis Investigative Site
    • California
      • Anaheim, California, United States, 92801
        • Novartis Investigative Site
      • Torrance, California, United States, 90502
        • Novartis Investigative Site
    • Florida
      • Atlantis, Florida, United States, 33462
        • Novartis Investigative Site
      • Chiefland, Florida, United States, 32626
        • Novartis Investigative Site
    • Illinois
      • Aurora, Illinois, United States, 60504
        • Novartis Investigative Site
      • Peoria, Illinois, United States, 61602
        • Novartis Investigative Site
    • Indiana
      • Evansville, Indiana, United States, 47714
        • Novartis Investigative Site
    • Louisiana
      • Slidell, Louisiana, United States, 70458
        • Novartis Investigative Site
    • Minnesota
      • Minneapolis, Minnesota, United States, 55417
        • Novartis Investigative Site
    • Missouri
      • St. Louis, Missouri, United States, 63110
        • Novartis Investigative Site
    • New York
      • Buffalo, New York, United States, 14215
        • Novartis Investigative Site
      • Laurelton, New York, United States, 11422
        • Novartis Investigative Site
    • Ohio
      • Marion, Ohio, United States, 43302
        • Novartis Investigative Site
    • Tennessee
      • Oak Ridge, Tennessee, United States, 37830
        • Novartis Investigative Site
    • Texas
      • Dallas, Texas, United States, 75231
        • Novartis Investigative Site
      • Houston, Texas, United States, 77030
        • Novartis Investigative Site
      • Houston, Texas, United States, 77094
        • Novartis Investigative Site
      • Livingston, Texas, United States, 77351
        • Novartis Investigative Site
    • Washington
      • Tacoma, Washington, United States, 98405
        • Novartis Investigative Site

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age ≥ 18 years; CHF with New York Heart Association class II-IV; left ventricular ejection fraction ≤ 35%; on beta blockers

Exclusion Criteria:

  • Potassium > 5.2 mmol/l; estimated glomerular filtration rate < 30 ml/min/1.73 m2; systolic blood pressure <100 mmHg or > 180 mmHg; history of intolerance to recommended target doses of angiotensin converting enzyme inhibitors or angiotensin receptor blockers

Other protocol-defined inclusion/exclusion criteria may apply.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: LCZ696 Condensed
Up-titration to LCZ696 200 mg twice daily (bid) over 3 weeks
Drug: LCZ696
LCZ696 50 mg/100 mg/200 mg bid
Experimental: LCZ696 Conservative
Up-titration to LCZ696 200 mg bid over 6 weeks
Drug: LCZ696
LCZ696 50 mg/100 mg/200 mg bid

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Number of Participants Experiencing Hypotension, Renal Dysfunction, Hyperkalemia and Angioedema and by Renin-Angiotensin-Aldosterone System (RAAS) Stratum (High vs. Low)
Time Frame: 12 weeks
Participants experiencing hypotension, renal dysfunction, hyperkalemia and angioedema and by Renin-Angiotensin-Aldosterone System (RAAS) stratum (high vs. low) High RAAS stratum Patients receiving > 160 mg of valsartan or > 10 mg total daily dose of enalapril, or equivalent doses of other ARBs/ACEIs, respectively, at screening Low RAAS stratum: Patients receiving ≤ 160 mg of valsartan or ≤ 10 mg total daily dose of enalapril, or equivalent doses of other ARBs/ACEIs, respectively, at screening. This stratum also included patients who were not on an ACEI or an ARB 4 weeks prior to screening (i.e., ACEI/ARB-naïve patients)
12 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Number of Participants Who Achieved Treatment Success Over the 12 Weeks and by Renin-Angiotensin-Aldosterone System (RAAS) Stratum (High vs. Low)
Time Frame: 12 weeks
Treatment success was defined as the number of participants who achieved and maintained LCZ696 200 mg bid without any dose interruption or down-titration over 12 weeks and by Renin-Angiotensin-Aldosterone System (RAAS) stratum (high vs. low) High RAAS stratum Patients receiving > 160 mg of valsartan or > 10 mg total daily dose of enalapril, or equivalent doses of other ARBs/ACEIs, respectively, at screening Low RAAS stratum: Patients receiving ≤ 160 mg of valsartan or ≤ 10 mg total daily dose of enalapril, or equivalent doses of other ARBs/ACEIs, respectively, at screening. This stratum also included patients who were not on an ACEI or an ARB 4 weeks prior to screening (i.e., ACEI/ARB-naïve patients)
12 weeks
Number of Participants Who Tolerated Study Medication for at Least the Last Two Weeks of the Study and by Renin-Angiotensin-Aldosterone System (RAAS) Stratum (High vs. Low).
Time Frame: 12 weeks
Tolerability was assessed as the number of participants who achieved LCZ696 200 mg bid and maintained this dose for at least 2 weeks before study completion, regardless of previous dose interruption or down-titration and by Renin-Angiotensin-Aldosterone System (RAAS) stratum (high vs. low) High RAAS stratum Patients receiving > 160 mg of valsartan or > 10 mg total daily dose of enalapril, or equivalent doses of other ARBs/ACEIs, respectively, at screening Low RAAS stratum: Patients receiving ≤ 160 mg of valsartan or ≤ 10 mg total daily dose of enalapril, or equivalent doses of other ARBs/ACEIs, respectively, at screening. This stratum also included patients who were not on an ACEI or an ARB 4 weeks prior to screening (i.e., ACEI/ARB-naïve patients)
12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Novartis Pharmaceuticals

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 1, 2013

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 1, 2014

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
August 1, 2014

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 12, 2013

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 13, 2013

First Posted (Estimate)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 14, 2013

Study Record Updates

Last Update Posted (Estimate)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
October 15, 2015

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 16, 2015

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2015

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • CLCZ696B2228
  • 2013-001835-33 (EudraCT Number)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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