- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04405804
Early Administration of Ivabradine in Children With Heart Failure (EASI-Child)
A Monocentric, Open Label, Single Arm, Pilot Study on the Early Administration of Ivabradine in Children Aged >6 Months and <18 Years With Dilated Cardiomyopathy and Acute Heart Failure
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The study is divided into a screening and enrollment visit (V1) where eligibility for treatment will be confirmed. Ivabradine will be administered to eligible patients with increasing dosage during the titration period (TP) which will last from a minimum of 3 days to a maximum of 15 days. This will be followed by a maintenance period (MP) of the drug for a further 14 days. The follow-up period (FU) will last 4 months.
The dose of ACE inhibitors will be introduced after 72 hours of clinical stability after the introduction of titrated ivabradine at maximum dose according to protocol. The anti-aldosterone will be introduced 24 hours after the introduction of ivabradine. The diuretic will not be modified during the titration phase of the drug, unless there is clinical necessity.
During the FU ivabradine will be continued at stable dosage, in order to maintain the target heart rate (HR) reached during the maintenance phase (HR > 80 bpm, in the group of patients older than 6-12 months, or HR > 70 bpm in patients aged 1-3 years or HR > 50 bpm between 3-18 years). In all patients, the drug dose will be decreased or discontinued in case of bradycardia (HR< 80 bpm in patients 6-12 months, HR< 70 bpm in patients 1-3 years of age or HR< 60 bpm in patients 3-18 years of age) and/or symptoms related to bradycardia or for other safety reasons.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Rome, Italy
- Bambino Gesù Hospital and Research Institute
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Dilated cardiomyopathy defined according to the indications of the Cardiomyopathy Task Force (dilation > 2 Standard Deviations (SD) and hypokinesia);
- Class NYHA/Ross ≥ II;
- Ejection fraction < 40%;
- Patients with acute heart failure episodes (both new episode and relapse) in the last three months;
- Systolic blood pressure > 50° age and height;
- Heart rate: 6-12 months: ≥105 bpm, >1 year <3 years: ≥95 bpm, 3-5 years: ≥75 bpm, 5-18 years: >70 bpm.
Exclusion Criteria:
- Cardiogenic shock in the three months;
- Hypertrophic, restrictive or mixed cardiomyopathy;
- Acute lymphocytic myocarditis diagnosed with endomyocardial biopsy;
- Significant Valvular Pathology;
- Sinus block and congenital long QT syndrome;
- Atrial Fibrillation;
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels > 2.5 times normal, bilirubin > 3 and creatinine > 2.5 mg/dL;
- Pregnancy and/or positive pregnancy test patients;
- Hypersensitivity to the active substance or any of the excipients;
- Participation in a clinical trial in which an experimental drug was administered within 30 days or 5 half-lives of the investigational drug;
- Chronic lung disease or other clinical condition that the investigating physician believes is incompatible with the study;
- eGFR <15 mL/min/1.73 m2.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Ivabradine
Eligible patients will be given treatment with ivabradine during a titration period which will last from a minimum of 3 days to a maximum of 15 days.
This will be followed by a maintenance period of another 14 days.
At the end of maintenance period, primary endpoint will be assessed.
After maintenance period, the patient will continue ivabradine at the same dosage during a follow-up period that will last 4 months.
|
Initial dose of ivabradine will be: 0.02 mg/kg/dose twice daily in patients between 6-12 months 0.05 mg/kg/dose twice daily in patients between 1-3 years and 3-18 years with a weight < 40 kg 2.5 mg/day in patients between 3-18 years with weight > 40 kg During titration phase, the dose may be increased, maintained, reduced or discontinued in accordance with titration rules. The titration rules will be adjusted on the basis of age subset and of each patient's evaluation during the titration phase, whether or not the target heart rate is reached (HR ≥ 20% compared to baseline HR) and whether or not are present bradycardia (HR should be greater than predefined by a HR threshold per age subset) and/or bradycardia-related symptoms. Maximum dose to be reached will be: 0.2 mg/kg/dose twice daily in patients between 6-12 months 0.3 mg/kg/dose twice daily in patients between 1-3 years and 3-18 years with a weight < 40 kg 15 mg/day in patients between 3-18 years, weight > 40 kg |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Heart rate in b.p.m. (mean (±SD) difference from baseline) at the end of maintenance
Time Frame: At the end of the two weeks maintenance period (17-29 days from enrollment)
|
To assess the response to ivabradine on heart rate after 14 days of stable therapy
|
At the end of the two weeks maintenance period (17-29 days from enrollment)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Heart rate in b.p.m. (mean (±SD) difference from baseline) at the end of follow-up
Time Frame: At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
To assess the response to ivabradine on heart rate after 16 weeks of follow-up
|
At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
Serum NT-proBNP in pg/mL (mean (±SD) difference from baseline) at the end of maintenance
Time Frame: At the end of the two weeks maintenance period (17-29 days from enrollment)
|
To assess the response to ivabradine on serum NT-proBNP levels after 14 days of stable therapy
|
At the end of the two weeks maintenance period (17-29 days from enrollment)
|
Serum NT-proBNP in pg/mL (mean (±SD) difference from baseline) at the end of follow-up
Time Frame: At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
To assess the response to ivabradine on serum NT-proBNP levels after 16 weeks of follow-up
|
At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
Correlation between heart rate and NT-proBNP value (Pearson correlation) at the end of maintenance
Time Frame: At the end of the two weeks maintenance period (17-29 days from enrollment)
|
To assess the correlation between heart rate and serum NT-proBNP levels after 14 days of stable therapy
|
At the end of the two weeks maintenance period (17-29 days from enrollment)
|
Correlation between heart rate and NT-proBNP value (Pearson correlation) at the end of follow-up
Time Frame: At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
To assess the correlation between heart rate and serum NT-proBNP levels after 16 weeks of follow-up
|
At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
Left ventricular function, calculated by 2D echocardiographic technique (calculation of left ventricular volume and ejection fraction - mean (±SD) difference from baseline) at the end of maintenance
Time Frame: At the end of the two weeks maintenance period (17-29 days from enrollment)
|
To assess EF, Left Ventricular End Diastolic Volume (LVEDV), Left Ventricular End Systolic Volume (LVESV) after 14 days of stable therapy
|
At the end of the two weeks maintenance period (17-29 days from enrollment)
|
Left ventricular function, calculated by 2D echocardiographic technique (calculation of left ventricular volume and ejection fraction - mean (±SD) difference from baseline) at the end of follow-up
Time Frame: At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
To assess EF, LVSV, LVDV after 16 weeks of follow-up
|
At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
Systolic blood pressure in mmHg (mean (±SD) difference from baseline) at the end of maintenance
Time Frame: At the end of the two weeks maintenance period (17-29 days from enrollment)
|
To assess the response to ivabradine on systolic blood pressure after 14 days of stable therapy
|
At the end of the two weeks maintenance period (17-29 days from enrollment)
|
Systolic blood pressure in mmHg (mean (±SD) difference from baseline) at the end of follow-up
Time Frame: At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
To assess the response to ivabradine on systolic blood pressure after 16 weeks of follow-up
|
At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
Use of inotropic drugs (number and % of patients who had to use inotropes at the end of maintenance)
Time Frame: At the end of the two weeks maintenance period (17-29 days from enrollment)
|
To assess the need to resort to inotropic drugs within 14 days of stable ivabradine therapy
|
At the end of the two weeks maintenance period (17-29 days from enrollment)
|
Use of inotropic drugs (number and % of patients who had to use inotropes at the end of follow-up)
Time Frame: At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
To assess the need to resort to inotropic drugs within 16 weeks of follow-up
|
At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
Number and % of dropouts at the end of maintenance
Time Frame: At the end of the two weeks maintenance period (17-29 days from enrollment)
|
To assess the frequency of patients who exit from the study within 14 days of stable ivabradine therapy
|
At the end of the two weeks maintenance period (17-29 days from enrollment)
|
Number and % of dropouts at the end of follow-up
Time Frame: At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
To assess the frequency of patients who exit from the study within 16 weeks of follow-up
|
At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
Time (days) from start of ivabradine therapy and new episode of acute heart failure, and/or implantation of mechanical assist device at the end of follow up
Time Frame: At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
To assess the period within main cardiological events would occur after the start of ivabradine therapy
|
At the end of the 16 weeks follow-up period (129-141 days from enrollment)
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Rachele Adorisio, MD, Bambino Gesù Hospital and Research Institute
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1986 / 2019
- 2019-003902-29 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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 Dilated Cardiomyopathy
-
Bristol-Myers SquibbTerminatedPrimary Familial Dilated CardiomyopathyUnited States, Germany, Spain, United Kingdom
-
Hospital General Universitario Gregorio MarañonMinisterio de Sanidad, Servicios Sociales e IgualdadUnknownPrimary Idiopathic Dilated CardiomyopathySpain
-
Nantes University HospitalCompleted
-
IRCCS SYNLAB SDNCompletedPatients With Ischemic or Idiopathic Dilated CardiomyopathyItaly
-
Capricor Inc.National Heart, Lung, and Blood Institute (NHLBI); National Institutes of Health... and other collaboratorsUnknownHeart Failure | Ischemic Cardiomyopathy | Nonischemic Cardiomyopathy | Dilated Cardiomyopathy (DCM)United States
-
Ray HershbergerNational Heart, Lung, and Blood Institute (NHLBI); National Human Genome Research...Active, not recruiting
-
University of TehranCompletedDilated CardiomyopathyIran, Islamic Republic of
-
McGill University Health Centre/Research Institute...Unknown
-
Chung Shan Medical UniversityCompletedPediatric Dilated CardiomyopathyTaiwan
-
Qingdao UniversityUnknownDilated CardiomyopathyChina
Clinical Trials on Ivabradine 5Mg Tab
-
Cairo UniversityCompleted
-
Beijing Anzhen HospitalNot yet recruiting
-
Chong Kun Dang PharmaceuticalCompletedRheumatoid ArthritisKorea, Republic of
-
Yonsei UniversityUnknownChronic Hepatitis B With Significant Hepatic Fibrosis With Type 2 DiabetesKorea, Republic of
-
Assistance Publique - Hôpitaux de ParisRecruiting
-
Hanlim Pharm. Co., Ltd.CompletedHealthy VolunteersKorea, Republic of
-
Cairo UniversityUnknownErectile DysfunctionEgypt
-
Asan Medical CenterInstitut de Recherches Internationales ServierCompletedHealthy IndividualKorea, Republic of
-
Far Eastern Memorial HospitalCompletedOveractive BladderTaiwan
-
HLB Pharmaceutical Co., Ltd.CompletedSpinocerebellar DegenerationKorea, Republic of