- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02678312
Study to Evaluate Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of LCZ696 Followed by a 52-week, Double-blind Study of LCZ696 Compared With Enalapril in Pediatric Patients With Heart Failure
Multicenter, Open-label Study to Evaluate Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of LCZ696 Followed by a 52-week Randomized, Double-blind, Parallel Group, Active-controlled Study to Evaluate the Efficacy and Safety of LCZ696 Compared With Enalapril in Pediatric Patients From 1 Month to < 18 Years of Age With Heart Failure Due to Systemic Left Ventricle Systolic Dysfunction
This study consists of two parts (Part 1 and Part 2). The purpose of Part 1 is to evaluate the way the body absorbs, distributes, metabolizes and removes the drug LCZ696. This will help determine the proper dose of LCZ696 for Part 2 of the study.
The purpose for Part 2 is to compare the effectiveness and safety of LCZ696 with enalapril in a double-blind manner, in pediatric heart failure patients over 52 weeks of treatment.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This study consists of two parts (Part 1 and Part 2). The purpose of Part 1 is to evaluate the way the body absorbs, distributes, metabolizes and removes the drug LCZ696. This will help determine the proper dose of LCZ696 for Part 2 of the study.
The purpose for Part 2 is to compare the effectiveness and safety of LCZ696 with enalapril in a double-blind manner, in pediatric heart failure patients over 52 weeks of treatment.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
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Buenos Aires
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Ramos Mejia, Buenos Aires, Argentina, B1704ETD
- Novartis Investigative Site
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Provincia De Salta
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Ciudad de Salta, Provincia De Salta, Argentina, A4406BPF
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Innsbruck, Austria, 6020
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Sofia, Bulgaria, 1309
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Alberta
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Edmonton, Alberta, Canada, T6G 1C9
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Ontario
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Toronto, Ontario, Canada, M5G 1X8
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Beijing, China, 100037
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Shanghai, China, 200127
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Shanghai, China, 200062
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Guangdong
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Guangzhou, Guangdong, China, 510623
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Zagreb, Croatia, 10000
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Praha 5, Czechia, 150 06
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Helsinki, Finland, 00290
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Montpellier, France, 34295 CEDEX 5
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Paris, France, 75015
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Pessac, France, 33600
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Berlin, Germany, 13353
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Erlangen, Germany, 91054
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Freiburg, Germany, 79106
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Heidelberg, Germany, 69120
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Leipzig, Germany, 04289
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Stuttgart, Germany, 70174
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Budapest, Hungary, H 1096
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Delhi
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New Delhi, Delhi, India, 110 060
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New Delhi, Delhi, India, 110076
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Gujarat
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Ahmedabad, Gujarat, India, 380 060
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Kerala
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Kochi, Kerala, India, 682041
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Be'er-Sheva, Israel, 84101
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Napoli, Italy, 80131
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BG
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Bergamo, BG, Italy, 24127
- Novartis Investigative Site
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BO
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Bologna, BO, Italy, 40138
- Novartis Investigative Site
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FI
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Firenze, FI, Italy, 50132
- Novartis Investigative Site
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MI
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Milano, MI, Italy, 20162
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PD
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Padova, PD, Italy, 35128
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RM
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Roma, RM, Italy, 00165
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TO
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Torino, TO, Italy, 10126
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Saitama, Japan, 330 8777
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Aichi
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Obu, Aichi, Japan, 474 8710
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Hokkaido
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Sapporo city, Hokkaido, Japan, 060 8648
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Nagasaki
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Omura, Nagasaki, Japan, 856-8562
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Tokyo
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Bunkyo ku, Tokyo, Japan, 113 8655
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Setagaya-ku, Tokyo, Japan, 157-8535
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Shinjuku ku, Tokyo, Japan, 162 8666
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Toyama
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Toyama-city, Toyama, Japan, 930-0194
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JOR
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Amman, JOR, Jordan, 11183
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Seoul, Korea, Republic of, 03080
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Seoul, Korea, Republic of, 06351
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Seoul, Korea, Republic of, 03722
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Gyeongsangnam Do
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Yangsan, Gyeongsangnam Do, Korea, Republic of, 50612
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Beirut, Lebanon
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El Achrafîyé, Lebanon, 166830
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Gdansk, Poland, 80-952
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Warszawa, Poland, 04 730
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Coimbra, Portugal, 3000 075
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Lisboa, Portugal, 1169 024
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Lisboa
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Carnaxide, Lisboa, Portugal, 2799 523
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Moscow, Russian Federation, 125412
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Saint Petersburg, Russian Federation, 197341
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Riyadh, Saudi Arabia, 11211
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Singapore, Singapore, 229899
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Madrid, Spain, 28046
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Madrid, Spain, 28009
- Novartis Investigative Site
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Andalucia
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Cordoba, Andalucia, Spain, 14004
- Novartis Investigative Site
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Cataluna
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Barcelona, Cataluna, Spain, 08950
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Catalunya
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Barcelona, Catalunya, Spain, 08035
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Lausanne, Switzerland, 1011
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Kaohsiung City, Taiwan, 83301
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Taipei, Taiwan, 10041
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Bangkok, Thailand, 10400
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Bangkok
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Bangkoknoi, Bangkok, Thailand, 10700
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Ankara, Turkey, 06490
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Izmir, Turkey, 35040
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Konak, Turkey, 35210
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California
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Loma Linda, California, United States, 92354
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Los Angeles, California, United States, 90027
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Los Angeles, California, United States, 90095
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Palo Alto, California, United States, 94304
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San Diego, California, United States, 92123
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Colorado
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Aurora, Colorado, United States, 80045
- Novartis Investigative Site
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Florida
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Gainesville, Florida, United States, 32610
- Novartis Investigative Site
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Miami, Florida, United States, 33136
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Saint Petersburg, Florida, United States, 33701
- Novartis Investigative Site
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Georgia
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Atlanta, Georgia, United States, 30322
- Novartis Investigative Site
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Indiana
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Indianapolis, Indiana, United States, 46202
- Novartis Investigative Site
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Novartis Investigative Site
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Michigan
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Ann Arbor, Michigan, United States, 48109-5238
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Minnesota
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Minneapolis, Minnesota, United States, 55455
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Rochester, Minnesota, United States, 55905
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Missouri
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Saint Louis, Missouri, United States, 63110
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New York
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New York, New York, United States, 10029
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New York, New York, United States, 10032
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North Carolina
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Charlotte, North Carolina, United States, 28203
- Novartis Investigative Site
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Ohio
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Cleveland, Ohio, United States, 44195
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104 4399
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Pittsburgh, Pennsylvania, United States, 15224
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Texas
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Dallas, Texas, United States, 75235
- Novartis Investigative Site
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Utah
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Salt Lake City, Utah, United States, 84113
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Washington
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Seattle, Washington, United States, 98105
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Key Inclusion Criteria:
- Chronic heart failure (CHF) resulting from left ventricular systolic dysfunction, and receiving chronic HF therapy (if not newly diagnosed)
- New York Heart Association (NYHA) classification II-IV (older children: 6 to <18 years old) or Ross CHF classification II-IV (younger children: < 6 years old)
- Systemic left ventricular ejection fraction ≤ 45% or fractional shortening ≤22.5%
- For Part 1 study: Patients must be treated with an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB) prior to screening. Patients in Group 1 and 2 must be currently treated with the dose equivalent of at least enalapril 0.2 mg/kg prior to the LCZ696 3.1 mg/kg administration. Group 3 patients will participate in LCZ696 0.8 mg/kg and not LCZ696 3.1 mg/kg.
- Biventricular physiology with systemic left ventricle
Key Exclusion Criteria:
- Patient with single ventricle or systemic right ventricle
- Patients listed for heart transplantation (as United Network for Organ Sharing status 1A) or hospitalized waiting for transplant (while on inotropes or with ventricular assist device)
- Sustained or symptomatic dysrhythmias uncontrolled with drug or device therapy
- Patients that have had cardiovascular surgery or percutaneous intervention to palliate or correct congenital cardiovascular malformations within 3 months of the screening visit. Patients anticipated to undergo corrective heart surgery during the 12 months after entry into Part 2
- Patients with unoperated obstructive or severe regurgitant valvular (aortic, pulmonary, or tricuspid) disease, or significant systemic ventricular outflow obstruction or aortic arch obstruction
- Patients with restrictive or hypertrophic cardiomyopathy
- Active myocarditis
- Renal vascular hypertension (including renal artery stenosis)
- Moderate-to severe obstructive pulmonary disease
- Serum potassium > 5.3 mmol/L
- History of angioedema
- Allergy or hypersensitivity to ACEI / ARB
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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EXPERIMENTAL: Part 1: LCZ696 open label
LCZ696 open label: For Age Groups 1 and 2, either 1) 0.8 mg/kg or 2) 3.1 mg/kg or both.
For Age Group 3, either 1) 0.4 mg/kg or 2) 1.6 mg/kg or both.
After LCZ696 PK assessment, patients will be maintained on open-label Enalapril provided locally by the study site, or standard of care also provided locally by the study site, for heart failure treatment, if patient intended to participate in Part 2.
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LCZ696: 3.125 mg granules (packaged in capsules containing 4 or 10 granules)
Enalapril tablets: 2.5 mg, 5 mg, 10 mg dosage strengths
LCZ696: 3.125 mg granules (packaged in capsules containing 4 or 10 granules), tablets: 50 mg, 100 mg, 200 mg dosage strengths
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ACTIVE_COMPARATOR: Part 2: Enalapril
The target dose for enalapril is 0.2 mg/kg bid (0.4 mg/kg total daily dose) with a maximum dose of 10 mg bid (20 mg total daily dose).
Administered in a double-blind fashion.
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Enalapril tablets: 2.5 mg, 5 mg, 10 mg dosage strengths
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EXPERIMENTAL: Part 2: LCZ696
LCZ696 3.125 mg granules and adult formulation (50, 100, 200 mg) can be given based on patient weight.
Administered in a double-blind fashion.
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LCZ696: 3.125 mg granules (packaged in capsules containing 4 or 10 granules)
LCZ696: 3.125 mg granules (packaged in capsules containing 4 or 10 granules), tablets: 50 mg, 100 mg, 200 mg dosage strengths
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Maximum Drug Concentration in Plasma (Cmax)
Time Frame: Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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The analyses of Cmax was based on plasma concentrations of three sacubitril/valsartan analytes (AHU377 (sacubitril), LBQ657 (sacubitrilat), and valsartan).
The plasma levels of sacubitril/valsartan analytes were determined using a validated LCMS/MS method with a lower limit of quantitation (LLOQ) of 1 ng/mL for sacubitril, 20 ng/mL for LBQ657, and 10 ng/mL for valsartan.
The PK parameters were determined using the non-compartmental method(s).
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Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Time to Maximum Plasma Concentration (Tmax)
Time Frame: Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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The analyses of Tmax was based on plasma concentrations of three sacubitril/valsartan analytes (AHU377 (sacubitril), LBQ657 (sacubitrilat), and valsartan).
The plasma levels of sacubitril/valsartan analytes were determined using a validated LCMS/MS method with a lower limit of quantitation (LLOQ) of 1 ng/mL for sacubitril, 20 ng/mL for LBQ657, and 10 ng/mL for valsartan.
The PK parameters were determined using the non-compartmental method(s).
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Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUCinf)
Time Frame: Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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The analyses of AUCinf was based on plasma concentrations of three sacubitril/valsartan analytes (AHU377 (sacubitril), LBQ657 (sacubitrilat), and valsartan).
The plasma levels of sacubitril/valsartan analytes were determined using a validated LCMS/MS method with a lower limit of quantitation (LLOQ) of 1 ng/mL for sacubitril, 20 ng/mL for LBQ657, and 10 ng/mL for valsartan.
The PK parameters were determined using the non-compartmental method(s).
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Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Number of Participants With Area Under the Plasma Concentration-time Curve From Time Zero to Last (AUClast)
Time Frame: Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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As prespecified in protocol and SAP the analysis of this outcome measure was done based on dose of LCZ696 administered within the different age groups.
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Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, and Valsartan): Clearance From Plasma (CL/F)
Time Frame: Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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The analyses was based on plasma concentrations of two sacubitril/valsartan analytes (AHU377 (sacubitril), and valsartan).
The plasma levels of sacubitril/valsartan analytes were determined using a validated LCMS/MS method with a lower limit of quantitation (LLOQ) of 1 ng/mL for sacubitril, 20 ng/mL for LBQ657, and 10 ng/mL for valsartan.
The PK parameters were determined using the non-compartmental method(s).
CL/F was not estimated for LBQ657 as it is a metabolite.
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Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril): Time Required to Drug Concentration to Decrease by Half (T 1/2)
Time Frame: Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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The analyses of T1/2 was based on plasma concentrations of sacubitril.
The plasma levels of sacubitril/valsartan analytes were determined using a validated LCMS/MS method with a lower limit of quantitation (LLOQ) of 1 ng/mL for sacubitril, 20 ng/mL for LBQ657, and 10 ng/mL for valsartan.
The PK parameters were determined using the non-compartmental method(s).
T1/2 for other analytes of LCZ696 (LBQ657 and Valsartan) was not estimable due to the short sample collection timeframe.
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Age group 1: Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3: Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2
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Part 1: Pharmacodynamics (PD) of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Change From Baseline in Plasma B-type Natriuretic Peptide (BNP)
Time Frame: Baseline (0 hrs pre dose), 4 and 8 hrs post dose on Day 1 of Period 1 and Period 2
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Biomarkers were used to assess the PD effects of LCZ696.
Blood biomarkers of potential interest included plasma BNP.
Biomarkers related to heart failure or the mechanism of action of the study drug were measured.
Summary statistics for change from baseline at each time point is presented.
The baseline assessment is defined as the last non-missing assessment (scheduled or unscheduled) prior to (the first dose time of the study drug within the dose associated period).
For each post-dose time point, participants are included if and only if the participant has both pre-dose assessment and current time point assessment observed.
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Baseline (0 hrs pre dose), 4 and 8 hrs post dose on Day 1 of Period 1 and Period 2
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Part 1: Pharmacodynamics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Change From Baseline in Plasma N-terminal Pro-brain Natriuretic Peptide (NTproBNP)
Time Frame: Baseline (0 hrs pre dose) and optional 24 hrs post dosing on Day 1 of Period 1 and Period 2
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Biomarkers were used to assess the PD effects of LCZ696.
Blood biomarkers of potential interest included plasma NTproBNP.
Biomarkers related to heart failure or the mechanism of action of the study drug were measured.
Summary statistics for change from baseline at each time point is presented.
The baseline assessment is defined as the last non-missing assessment (scheduled or unscheduled) prior to (the first dose time of the study drug within the dose associated period).
For each post-dose time point, participants are included if and only if the participant has both pre-dose assessment and current time point assessment observed.
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Baseline (0 hrs pre dose) and optional 24 hrs post dosing on Day 1 of Period 1 and Period 2
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Part 1: Pharmacodynamics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Change From Baseline in Plasma Cyclic Guanosine Monophosphate (cGMP)
Time Frame: Baseline (0 hrs pre dose), 4 and 8 hrs post dose on Day 1 of Period 1 and Period 2
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Biomarkers were used to assess the PD effects of LCZ696.
Blood biomarkers of potential interest included plasma cGMP.
Biomarkers related to heart failure or the mechanism of action of the study drug were measured.
Summary statistics for change from baseline at each time point is presented.
The baseline assessment is defined as the last non-missing assessment (scheduled or unscheduled) prior to (the first dose time of the study drug within the dose associated period).
For each post-dose time point, participants are included if and only if the participant has both pre-dose assessment and current time point assessment observed.
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Baseline (0 hrs pre dose), 4 and 8 hrs post dose on Day 1 of Period 1 and Period 2
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Part 1: Pharmacodynamics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Change From Baseline in Urine cGMP
Time Frame: Baseline (0 hrs pre dose), 4 to 8 hrs post dose on Day 1 of Period 1 and Period 2
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Biomarkers were used to assess the PD effects of LCZ696.
Blood biomarkers of potential interest included urine cGMP.
Biomarkers related to heart failure or the mechanism of action of the study drug were measured.
Summary statistics for change from baseline at each time point is presented.
The baseline assessment is defined as the last non-missing assessment (scheduled or unscheduled) prior to (the first dose time of the study drug within the dose associated period).
For each post-dose time point, participants are included if and only if the participant has both pre-dose assessment and current time point assessment observed.
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Baseline (0 hrs pre dose), 4 to 8 hrs post dose on Day 1 of Period 1 and Period 2
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Part 2: Percentage of Participants With Worst Event in Each Category Based on Global Ranking
Time Frame: Up to 52 weeks
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Global ranking is based on 5 categories ranking worst to best outcome:Category 1:Death; United Network for Organ Sharing(UNOS)status 1A listing for heart transplant or equivalent; ventricular assist device(VAD)/extracorporeal membrane oxygenation(ECMO)/mechanical ventilation/intra-aortic balloon pump requirement for life support at end of study.
Category 2:Worsening HF(WHF);defined by signs and symptoms of WHF that requires an intensification of HF therapy.
Category 3:Worsened; worse New York Heart Association(NYHA)/Ross or worse Patient Global Impression of Severity(PGIS); and further ranking by Pediatric Quality of Life Inventory(PedsQL)physical functioning domain.Category 4:Unchanged; unchanged NYHA/Ross and unchanged PGIS; and further ranking by PedsQL physical functioning domain.
Category 5:Improved; improved NYHA/Ross or improved PGIS(neither can be worse);and further ranking by PedsQL physical functioning domain.
Participants with worst event in each category are reported here.
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Up to 52 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Part 1: Percentage of Participants With Treatment Emergent Adverse Events (TEAEs)
Time Frame: From first dose to 30 days after last dose of study drug in Part 1
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An adverse event (AE) is any untoward medical occurrence associated with use of a drug in humans, whether considered drug related or not, that occurs after a participant provides informed consent.
TEAEs during part 1 are defined as any recorded AE with its start date (recorded or imputed) later than or equal to the date of the first dose of the study drug within part 1 and its start date prior to or equal to the end date of the part 1.
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From first dose to 30 days after last dose of study drug in Part 1
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Part 2: Percentage of Participants With Treatment Emergent Adverse Events (TEAEs)
Time Frame: From first dose to 30 days after last dose of study drug in Part 2 (up to 56 weeks)
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An AE is any untoward medical occurrence associated with use of a drug in humans, whether or not considered drug related, that occurs after a participant provides informed consent.
TEAEs during part 2 are defined as any recorded AE with its start date (recorded or imputed) later than or equal to the date of the first dose of the study drug within part 2 and its start date prior to or equal to the end date of part 2.
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From first dose to 30 days after last dose of study drug in Part 2 (up to 56 weeks)
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Part 2: Exposure-adjusted Incidence Rate of Category 1 or Category 2 Event
Time Frame: 52 weeks
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The exposure adjusted incidence rate is calculated as number of participants with at least one event divided by total participant years across all participants.
Category 1: Death; UNOS status 1A listing for heart transplant or equivalent; VAD/ECMO/mechanical ventilation/intra-aortic balloon pump requirement for life support at end of study.
Category 2: WHF; defined by signs and symptoms of WHF that requires an intensification of HF therapy.
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52 weeks
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Part 2: Percentage of Participants With Change From Baseline in New York Heart Association (NYHA)/Ross Functional Class
Time Frame: Baseline, Week 4, 12, 24, 36, and 52
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NYHA classification is a subjective physician's assessment of participant's functional capacity and symptomatic status and can change frequently over time.
NYHA is tool that classifies participants with heart failure into one of four classes according to their degree of symptoms at rest and with activity.
Class I: No limitations of physical activity.
Class 2: May experience fatigue, palpitations, dyspnea, or angina during moderate exercise but not during rest.
Class 3: Symptoms with minimal exertion that interfere with normal daily activity.
Class 4: Unable to carry out any physical activity because they typically have symptoms of HF at rest that worsen with any exertion.
Participants with change from baseline were classified as improved (shifted from higher to lower class), unchanged (no change in class) or worsened (shifted from lower to higher class).
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Baseline, Week 4, 12, 24, 36, and 52
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Part 2: Percentage of Participants With Change From Baseline in Patient Global Impression of Severity (PGIS) Score
Time Frame: Baseline, Week 4, 12, 24, 36, and 52
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PGIS of Heart Failure Symptoms is a 1-item questionnaire to assess the participant's impression of symptoms severity, specifically: shortness of breath, fatigue and swelling.
The PGI-S asks the participant to choose one response that best describes how his/her heart failure symptoms, specifically: shortness of breath, fatigue and swelling are now on a 5-point scale, ranging from 'Not at all' (1) to 'Very severe' (5).
C1 = none (good), C2 = mild, C3 = moderate, C4 = severe, C5 = very severe (bad).
Percentage of participants by change in score are reported.
Participants with change from baseline were classified as improved (shifted from higher to score), unchanged (no change in score) or worsened (shifted from lower to higher score).
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Baseline, Week 4, 12, 24, 36, and 52
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Part 1 and Part 2: Population PK of LCZ696 Analytes: Clearance From Plasma (CL)
Time Frame: Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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The analyses of CL was based on plasma concentrations of three sacubitril/valsartan analytes (AHU377 (sacubitril), LBQ657 (sacubitrilat), and valsartan).
The PK parameters were determined using the non-compartmental method(s).
In case of data limitations for estimating PK parameters using non-compartmental methods, a population PK approach was used to estimate exposure of sacubitril/valsartan analytes.
The population PK model was developed to describe incoming data from pediatric patients based on an established model developed for the adult population.
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Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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Part 1 and Part 2: Population PK of LCZ696 Analytes: Volume of Distribution in Steady State
Time Frame: Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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The analyses of volume of distribution was based on plasma concentrations of three sacubitril/valsartan analytes (AHU377 (sacubitril), LBQ657 (sacubitrilat), and valsartan).
The PK parameters were determined using the non-compartmental method(s).
In case of data limitations for estimating PK parameters using non-compartmental methods, a population PK approach was used to estimate exposure of sacubitril/valsartan analytes.
The population PK model was developed to describe incoming data from pediatric patients based on an established model developed for the adult population.
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Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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Part 1 and Part 2: Population PK of LCZ696 Analytes: Absorption Rate Constant (Ka)
Time Frame: Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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The analyses of Ka was based on plasma concentrations of three sacubitril/valsartan analytes (AHU377 (sacubitril), LBQ657 (sacubitrilat), and valsartan).
The PK parameters were determined using the non-compartmental method(s).
In case of data limitations for estimating PK parameters using non-compartmental methods, a population PK approach was used to estimate exposure of sacubitril/valsartan analytes.
The population PK model was developed to describe incoming data from pediatric patients based on an established model developed for the adult population.
|
Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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Part 1 and Part 2: Population PK of LCZ696 Analytes: Time Required to Drug Concentration to Decrease by Half (T 1/2)
Time Frame: Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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The analyses of T1/2 was based on plasma concentrations of three sacubitril/valsartan analytes (AHU377 (sacubitril), LBQ657 (sacubitrilat), and valsartan).
The PK parameters were determined using the non-compartmental method(s).
In case of data limitations for estimating PK parameters using non-compartmental methods, a population PK approach was used to estimate exposure of sacubitril/valsartan analytes.
The population PK model was developed to describe incoming data from pediatric patients based on an established model developed for the adult population.
|
Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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Part 1 and Part 2: Population PK of LCZ696 Analytes: Maximum Drug Concentration in Plasma at Steady State (Cmax,ss)
Time Frame: Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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The analyses of Cmax was based on plasma concentrations of three sacubitril/valsartan analytes (AHU377 (sacubitril), LBQ657 (sacubitrilat), and valsartan).
The PK parameters were determined using the non-compartmental method(s).
In case of data limitations for estimating PK parameters using non-compartmental methods, a population PK approach was used to estimate exposure of sacubitril/valsartan analytes.
The population PK model was developed to describe incoming data from pediatric patients based on an established model developed for the adult population.
|
Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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Part 1 and Part 2: Population PK of LCZ696 Analytes: Lowest Plasma Concentration Observed During a Dosing Interval at Steady State (Cmin,ss)
Time Frame: Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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The analyses of Cmin was based on plasma concentrations of three sacubitril/valsartan analytes (AHU377 (sacubitril), LBQ657 (sacubitrilat), and valsartan).
The PK parameters were determined using the non-compartmental method(s).
In case of data limitations for estimating PK parameters using non-compartmental methods, a population PK approach was used to estimate exposure of sacubitril/valsartan analytes.
The population PK model was developed to describe incoming data from pediatric patients based on an established model developed for the adult population.
|
Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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Part 1 and Part 2: Population PK of LCZ696 Analytes: Area Under the Plasma Concentration-time Curve From Time Zero to the End of the Dosing Interval Tau at Steady State (AUCtau,ss)
Time Frame: Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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The analyses of AUCtau was based on plasma concentrations of three sacubitril/valsartan analytes (AHU377 (sacubitril), LBQ657 (sacubitrilat), and valsartan).
The PK parameters were determined using the non-compartmental method(s).
In case of data limitations for estimating PK parameters using non-compartmental methods, a population PK approach was used to estimate exposure of sacubitril/valsartan analytes.
The population PK model was developed to describe incoming data from pediatric patients based on an established model developed for the adult population.
|
Part 1: Age group 1- Pre-dose and 0.5, 1, 2, 4, 8, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Age groups 2 and 3- Pre-dose and 1, 2, 4, 10, optional 24 hours post-dose on Day 1 of Period 1 and 2; Part 2: Weeks 2, 8, 12, 52
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Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Heart Failure
- Molecular Mechanisms of Pharmacological Action
- Antihypertensive Agents
- Enzyme Inhibitors
- Protease Inhibitors
- Angiotensin Receptor Antagonists
- Angiotensin-Converting Enzyme Inhibitors
- Enalaprilat
- Enalapril
- Sacubitril and valsartan sodium hydrate drug combination
Other Study ID Numbers
- CLCZ696B2319
- 2015-004207-22 (EUDRACT_NUMBER)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel based on scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.
This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
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.
Clinical Trials on Pediatric Heart Failure
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Bambino Gesù Hospital and Research InstituteEnrolling by invitation
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University of UtahCompleted
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National Institute of Allergy and Infectious Diseases...Clinical Trials in Organ Transplantation in ChildrenCompletedPediatric Heart Transplantation | Pediatric Heart Transplant Recipients | Pediatric Cardiac TransplantationUnited States
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SterileCare Inc.Not yet recruitingPediatric Intestinal Failure
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National Institute of Allergy and Infectious Diseases...National Heart, Lung, and Blood Institute (NHLBI)TerminatedPediatric Heart Transplantation | Pediatric Heart Transplant RecipientsUnited States, Canada
Clinical Trials on Placebo of LCZ696
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Novartis PharmaceuticalsCompletedChronic Heart Failure (CHF)Spain, Croatia, Taiwan, Germany, Italy, United States, Australia, Netherlands, Switzerland, Belgium, United Kingdom, Bulgaria, Lithuania, Russian Federation, France, Argentina, Korea, Republic of, Poland, Canada, Turkey
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Novartis PharmaceuticalsCompletedChronic Heart Failure With Reduced Ejection FractionBelgium, Estonia, Denmark, Greece, United Kingdom, Germany, Latvia, Lithuania, Spain, Netherlands, Bulgaria, Finland, Poland, Czechia, Iceland, Sweden, France, Ireland, Norway
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Novartis PharmaceuticalsCompletedHeart Failure and Reduced Ejection FractionUnited States
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Novartis PharmaceuticalsCompletedEssential HypertensionChina, Korea, Republic of, Taiwan, Hong Kong, Thailand, Philippines, Singapore
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Novartis PharmaceuticalsCompleted
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Novartis PharmaceuticalsCompletedHeart Failure With Reduced Ejection Fraction (HF-rEF)Japan
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Novartis PharmaceuticalsCompletedChronic Heart Failure With Reduced Ejection FractionGermany
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Novartis PharmaceuticalsCompletedHeart Failure | Erectile Dysfunction | Heart Failure, SystolicGermany
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Duke UniversityNational Heart, Lung, and Blood Institute (NHLBI)Completed