- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03541603
Hemodynamic Evaluation of Levosimendan in Patients With PH-HFpEF (HELP)
April 9, 2020 updated by: Tenax Therapeutics, Inc.
A Double-Blind, Randomized, Placebo-Controlled Study of Levosimendan in Pulmonary Hypertension Patients With Heart Failure and Preserved Left Ventricular Ejection Fraction (PH-HFpEF)
Phase 2 study to evaluate the efficacy and safety of intermittent levosimendan compared with placebo in hemodynamic improvement with exercise in PH-HFpEF subjects
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Levosimendan and its prolonged active metabolite, OR-1896, have been shown to have favorable hemodynamic effects in subjects with pulmonary hypertension and right heart failure.
Clinical studies that have been conducted in subjects with right heart failure and pulmonary hypertension suggest levosimendan may be an effective therapy in treatment of subjects with PH-HFpEF.
This study will provide demonstration of levosimendan/OR-1896's effectiveness in critical measures of hemodynamic response in weekly administration of levosimendan and the concomitant response as measured by exercise capacity, subject quality of life, and changes in functional capacity.
These data will support and guide the Phase 3 development of levosimendan in PH-HFpEF subjects.
Study Type
Interventional
Enrollment (Actual)
38
Phase
- 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
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California
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Stanford, California, United States, 94305
- Stanford Healthcare
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Illinois
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Chicago, Illinois, United States, 60611
- Northwestern Memorial Hospital
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Massachusetts
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital
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Boston, Massachusetts, United States, 02111
- Tufts Medical Center
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Boston, Massachusetts, United States, 02215
- Brigham and Women's Hospital
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Minnesota
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Minneapolis, Minnesota, United States, 55455
- University of Minnesota Medical Center
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Rochester, Minnesota, United States, 55905
- Mayo Clinic
-
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Nebraska
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Omaha, Nebraska, United States, 68198
- University of Nebraska Medical Center
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New York
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Manhasset, New York, United States, 11030
- North Shore University Hospital
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New York, New York, United States, 10029
- Ichan School of Medicine at Mount Sinai
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New York, New York, United States, 10021
- New York Presbyterian Hospital-Weill Cornell Medicine
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Ohio
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Cincinnati, Ohio, United States, 45219
- Christ Hospital
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Hospital of the University of Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15213
- University of Pittsburgh Presbyterian Hospital
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South Carolina
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Charleston, South Carolina, United States, 29425
- Medical University of South Carolina
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Wisconsin
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Madison, Wisconsin, United States, 53792
- UW Health University Hospital
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-
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
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
Criteria to enter Open-label, Lead-in Dose Phase:
- Diagnosis of WHO Group 2 Pulmonary Hypertension (PH) with heart failure and preserved ejection fraction (HFpEF) confirmed at the time of the diagnosis of pulmonary hypertension.
- Baseline Pulmonary Arterial Pressure (PAP) ≥35, PCWP ≥20, NYHA Class IIb/III, Left Ventricular Ejection Fraction (LVEF) ≥40%
- Ability to walk at least 50 meters, but not more than 550 meters in a six-minute walk test.
- Stable oxygen treatment (if applicable), and medications for heart failure, hypertension and respiratory condition
Criterion for Randomization to Double-blind Phase:
- Response to Open-label, Lead-in Levosimendan: Patients who demonstrate a ≥4mmHg reduction in PCWP from baseline measured at bicycle exercise (25 watts) with no more than a 10% decrease from baseline in cardiac index
Exclusion Criteria:
- Subject has primary diagnosis of PH other than Group 2 PH-HFpEF
- Previous Percutaneous Coronary Intervention (PCI) or cardiac surgery (CABG) , unless they have a negative stress test in last 12 months)
- Congenital heart disease
- Clinically significant lung disease
- Planned heart or lung surgery
- Cardiac Index >4.0 L/min/m2
- Concomitant administration of pulmonary vasodilator therapy or taken within 14 days
- Dialysis or Glomerular Filtration Rate (GFR) <30 mL/min/1.73 m2
- Liver dysfunction with Child Pugh Class B or C
- Evidence of systemic infection
- Weight > 150kg
- Symptomatic systolic blood pressure (SBP) cannot be managed to ensure SBP >100 mmHg
- Heart rate >= 100 bpm with study drug, symptomatic and persistent for at least 10 minutes
- Hemoglobin < 80 g/L
- Serum potassium < 3.0 mmol/L or > 5.5 mmol/L at baseline
- Patients having severely compromised immune function
- Pregnant, suspected to be pregnant, or breast-feeding
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 |
Intervention / Treatment |
---|---|
Experimental: Levosimendan 2.5mg/mL Injectable Solution
0.075 - 0.1µg/kg/min for 24 hrs (weekly)
|
A sterile 2.5 mg/mL concentrate solution that is diluted in 5% Dextrose or 0.9 Normal Saline to achieve a 50 microgram/min solution for infusion
Other Names:
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Placebo Comparator: Matching Placebo
0.075 - 0.1µg/kg/min for 24 hrs (weekly)
|
A sterile 2.5mg/mL concentrate solution that is diluted in 5% Dextrose or 0.9 Normal Saline to achieve a 50 microgram/min solution for infusion
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Change from baseline Pulmonary Capillary Wedge Pressure (PCWP) with bicycle exercise
Time Frame: Week 6
|
Week 6
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Cardiac Index (CI) at rest and with exercise
Time Frame: Week 6
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Week 6
|
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Change in Pulmonary Vascular Resistance (PVR) effect at rest and with exercise
Time Frame: Week 6
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Week 6
|
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Change in PCWP when supine and legs elevated
Time Frame: Week 6
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Week 6
|
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Patient global assessment
Time Frame: Week 6
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Patient assessment of well-being based on 6 questions assessed on a 5-point Likert Scale ( 1 =worst, 5= best)
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Week 6
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Exercise duration via 6 minute walk test
Time Frame: Week 6
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Week 6
|
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Physician's assessment of functional class
Time Frame: Week 6
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Physician's Assessment of New York Heart Association (NYHA) Classification (one of four categories based on how much the patient is limited during physical activity.
(Class I, no limitation of physical activity to Class IV, marked limitation of physical activity).
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Week 6
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Composite incidence of death or hospitalization
Time Frame: Week 6
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Week 6
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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
- Burkhoff D, Rich S, Pollesello P, Papp Z. Levosimendan-induced venodilation is mediated by opening of potassium channels. ESC Heart Fail. 2021 Dec;8(6):4454-4464. doi: 10.1002/ehf2.13669. Epub 2021 Oct 30.
- Burkhoff D, Borlaug BA, Shah SJ, Zolty R, Tedford RJ, Thenappan T, Zamanian RT, Mazurek JA, Rich JD, Simon MA, Chung ES, Raza F, Majure DT, Lewis GD, Preston IR, Rich S. Levosimendan Improves Hemodynamics and Exercise Tolerance in PH-HFpEF: Results of the Randomized Placebo-Controlled HELP Trial. JACC Heart Fail. 2021 May;9(5):360-370. doi: 10.1016/j.jchf.2021.01.015. Epub 2021 Apr 7.
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 (Actual)
November 14, 2018
Primary Completion (Actual)
April 7, 2020
Study Completion (Actual)
April 7, 2020
Study Registration Dates
First Submitted
May 3, 2018
First Submitted That Met QC Criteria
May 17, 2018
First Posted (Actual)
May 30, 2018
Study Record Updates
Last Update Posted (Actual)
April 10, 2020
Last Update Submitted That Met QC Criteria
April 9, 2020
Last Verified
April 1, 2020
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Respiratory Tract Diseases
- Lung Diseases
- Heart Failure
- Hypertension
- Hypertension, Pulmonary
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Vasodilator Agents
- Enzyme Inhibitors
- Protective Agents
- Cardiotonic Agents
- Phosphodiesterase Inhibitors
- Phosphodiesterase 3 Inhibitors
- Simendan
Other Study ID Numbers
- TNX-LVO-04
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
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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