- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05019027
N-of-1 for Beta-Blockers in Cardiac Amyloidosis
N-of-1 Trials to Promote Deprescribing in Older Adults With Transthyretin Cardiac Amyloidosis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Princess Osma, BA
- Phone Number: 646-962-5910
- Email: pro4001@med.cornell.edu
Study Contact Backup
- Name: Kate Zarzuela, MD
- Phone Number: 646-962-5909
- Email: kaz4004@med.cornell.edu
Study Locations
-
-
New York
-
New York, New York, United States, 10065
- Recruiting
- Weill Cornell Medicine
-
Principal Investigator:
- Parag Goyal, MD, MSc
-
Contact:
- Princess Osma, BA
- Phone Number: 646-962-5910
- Email: pro4001@med.cornell.edu
-
Contact:
- Kate Zarzuela, MD
- Phone Number: 646-962-5909
- Email: kaz4004@med.cornell.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Ambulatory adults age ≥65 years with TTR-cardiac amyloidosis (confirmed by PYP scan or biopsy)
- Taking beta-blocker
Exclusion Criteria:
Other compelling indication beta-blocker
- Angina symptoms
- Acute coronary syndrome, myocardial infarction or coronary artery bypass surgery in prior 3 years
- Atrial arrhythmia with hospitalization for rapid ventricular response, prior 1 year
- Sinus tachycardia >100 bpm, atrial arrhythmia with ventricular rate >90 beats per minute, systolic blood pressure >160 mmHg
Clinical instability (N-of-1 trials are appropriate for stable conditions only)
- Decompensated heart failure
- Hospitalized in past 30 days
- Medication changes or procedures in the prior 14 days that could confound observations, per the Principal Investigator's discretion
- Estimated life expectancy <6 months
- Moderate-severe dementia or psychiatric disorder precluding informed consent
- Language barrier that will preclude informed consent and ability to comprehend study procedures
- Non-compliance or inability to complete study procedures
- Enrollment in a clinical trial not approved for co-enrollment
- Any condition that, in Principal Investigator or treating physician's opinion, makes the patient unsuitable for study participation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: On-Off Sequence
This arm will follow an On-Off sequence.
This is the only arm in the study.
Subjects will begin in the On phase (Period 1), maintaining their beta-blocker dosage as previously prescribed to the subjects by their physician.
Subjects will then continue to the Off phase (Period 2) where they will down-titrate their beta-blocker by 50% each week until they are completely off the drug for a total of two weeks.
At the end of Period 2, the subjects will have their End of Intervention visit in which they will determine if they would like to continue or discontinue their beta-blockers for the foreseeable future.
|
The intervention is a single-arm crossover withdrawal/reversal design (On vs Off) with 2 total periods, each period lasting between up to 6 weeks. During the On period, subjects will be on their beta blocker. During the Off period, their beta blockers will be down-titrated by 50% each week and will be subsequently discontinued. Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The change in exercise capacity when on beta-blocker versus when off beta-blocker, as measured by peak oxygen consumption (VO2) during Cardiopulmonary Exercise Test (CPET).
Time Frame: End of Period 1 (Week 2, 3, 4, 5, or 6) and Period 2 (Week 8, 9, 10, 11, or 12)
|
To understand the changes in exercise capacity between the On and Off phase via a Peak oxygen consumption (VO2) Cardiopulmonary Exercise Test.
Cardiopulmonary exercise testing (CPET) measures breath-by-breath oxygen production during symptom-limited exercise on a stationary bike or treadmill.
This permits calculation of peak oxygen consumption (VO2).
Percent predicted peak VO2 for body weight will also be calculated.
|
End of Period 1 (Week 2, 3, 4, 5, or 6) and Period 2 (Week 8, 9, 10, 11, or 12)
|
The change in patient-reported health status when on beta-blocker versus when off beta-blocker, as measured by Kansas City Cardiomyopathy Questionnaire (KCCQ-12).
Time Frame: Baseline; Bi-weekly, End of Period 1 (Week 2, 3, 4, 5, or 6), End of Period 2 (Week 8, 9, 10, 11, or 12)
|
The Kansas City Cardiomyopathy Questionnaire (KCCQ-12) is a heart failure-specific health status survey.
Questions are ranked on 5- to 7-point Likert scales, with higher scores indicating better health status.
|
Baseline; Bi-weekly, End of Period 1 (Week 2, 3, 4, 5, or 6), End of Period 2 (Week 8, 9, 10, 11, or 12)
|
The change in patient-reported quality of life when on beta-blocker versus when off beta-blocker, as measured by the EuroQol-5d Visual Analogue Scale.
Time Frame: Baseline; End Period 1 (Weeks 2, 3, 4, 5, or 6), End of Period 2 (Weeks 8, 9, 10, 11, or 12)
|
The EuroQol-5D Visual Analogue System (EQ-5D VAS) indicates patient-perceived health on a vertical visual analogue scale.
The scale ranges from 0, indicating poorest health, to 100, indicating best health.
|
Baseline; End Period 1 (Weeks 2, 3, 4, 5, or 6), End of Period 2 (Weeks 8, 9, 10, 11, or 12)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in patient-reported quality of life when on beta-blocker, as measured by the Patient-Reported Outcome Measurement Information System-29 (PROMIS-29)
Time Frame: Baseline; Weekly for up to 12 weeks; End of Period 1 (Week 2, 3, 4, 5, or 6), Period 2 (Week 8, 9, 10, 11, or 12)
|
Patient-Reported Outcome Measurement Information System-29 (PROMIS-29) is a health-related quality of life survey, with questions from 6 domains: depression, anxiety, physical function, pain interference, sleep disturbance, and ability to engage in social roles and activities.
Questions are ranked on a 5-point Likert scale, with higher scores at times indicating better quality of life, and at other times indicating poorer quality of life.
There is a pain rating scale ranging from 0 to 10, with higher scores indicating higher pain level.
Scores are reported for each domain, as well as for pain rating.
|
Baseline; Weekly for up to 12 weeks; End of Period 1 (Week 2, 3, 4, 5, or 6), Period 2 (Week 8, 9, 10, 11, or 12)
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Parag Goyal, MD, MSc, Weill Medical College of Cornell University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- 21-07023710
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 Heart Diseases
-
Baker Heart and Diabetes InstitutePrincess Alexandra Hospital, Brisbane, Australia; Royal Perth Hospital; Alice... and other collaboratorsRecruitingHeart Failure | Valve Heart DiseaseAustralia
-
Medical University of ViennaUnknownHeart Diseases | Heart Failure | Valvular Heart DiseaseAustria
-
Centre Chirurgical Marie LannelongueActive, not recruitingValvular Heart Disease | Valve Disease, Heart
-
Aristotle University Of ThessalonikiRecruitingCardiovascular Diseases | Heart Failure | Valvular Heart Disease | Biochemical DysfunctionGreece
-
Abiomed Inc.RecruitingHeart Diseases | Acute Decompensated Heart Failure | Congestive Heart Failure | Acute Heart FailureUnited States
-
Kathirvel SubramaniamUniversity of Maryland, Baltimore; CSL BehringRecruitingHeart Failure,Congestive | Heart Disease End StageUnited States
-
Wuerzburg University HospitalRecruitingHeart Failure | Chronic Heart Failure | Chronic Heart DiseaseGermany
-
Wake Forest UniversityNational Institute on Aging (NIA)CompletedHeart Failure, Congestive | Diastolic Heart FailureUnited States
-
University of MichiganTerminatedDiastolic Heart Failure | Hypertensive Heart DiseaseUnited States
-
National Taiwan University HospitalRecruitingValve Heart DiseaseTaiwan
Clinical Trials on Beta blocker
-
Uppsala UniversityKarolinska Institutet; Oslo University Hospital; Göteborg University; New York... and other collaboratorsTerminatedMyocardial Infarction With Non-obstructive Coronary ArteriesNorway, Sweden, Australia, New Zealand, Spain
-
Università Vita-Salute San RaffaeleCompleted
-
Instituto Ecuatoriano de Enfermedades DigestivasUnknownCirrhosis | GastroIntestinal Bleeding | Gastric VarixEcuador
-
Korea UniversityUnknownCirrhosis | Variceal BleedingKorea, Republic of
-
Imam Abdulrahman Bin Faisal UniversityCompletedOne Lung Ventilation | Elective Thoracic SurgerySaudi Arabia
-
University Health Network, TorontoCompletedThoracic Surgery, Lung IsolationCanada
-
Istanbul UniversityNot yet recruiting
-
Sherief Abd-ElsalamRecruitingBeta Blocker ToxicityEgypt
-
Chongqing Medical UniversityRecruitingAcute Coronary SyndromeChina
-
Hannover Medical SchoolCharite University, Berlin, GermanyUnknownPostural Orthostatic Tachycardia SyndromeGermany