Heart Failure Clinical Trial
Official title:
Orodispersible Minitablets of Enalapril in Children With Heart Failure Due to Dilated Cardiomyopathy
Paediatric clinical trial in 50 children, from 1 month to less than 12 years of age, suffering from heart failure due to dilated cardiomyopathy, to obtain paediatric pharmacokinetic and pharmacodynamic data of enalapril and its active metabolite enalaprilat while treated for 8 weeks with enalapril in form of Orodispersible Minitablets (ODMTs), to describe the dose exposure in this patient population.
This clinical trial is one of three clinical trials of the European-Commission (FP7)-funded
"LENA" (Labeling of Enalapril from Neonates up to Adolescents) project: 50 children with
heart failure due to dilated cardiomyopathy (LENA-Work Package (WP) 08 Trial) and 50
children with heart failure due to congenital heart disease (LENA-WP09 Trial) get treated
with an optimal dose of enalapril ODMTs for up to 8 weeks after thorough, individualised
titration and get invited to join the 10 months Safety Follow-up Study (LENA-WP10 Trial).
In this WP08 Trial children between 1 month and less than 12 years, naive to enalapril
treatment or switched from an Angiotensin-Converting Enzyme (ACE)-Inhibitor pre-treatment,
receive an Initial Dose to investigate the reaction over 8 hours before a decision on the
first dose is made. Always up to 7 days later a next higher dose is given at the hospital,
the patient is supervised for 4 and then always 2 hours before a decision on the prescribed
dose for the next dosing period is made. In this study protocol a target dose similar to the
adult target dose (20 mg of Enalapril in a 70 year old adult result in 0.282 mg/kg/day
enalapril) is defined. Enalapril ODMTs of 0.25 mg and 1 mg are available to allow for an
individual dose titration scheme.
Weight-dependently, pharmacokinetic (PK) and pharmacodynamic (PD) data are collected once in
a full PK/PD day over 12, respectively 6 hours, and single PK/PD samples at each Dose
Titration Visit and each bi-weekly Study Control Visit until the Last Visit after 8 weeks of
treatment. Blood pressure and renal monitoring is performed at each visit before deciding on
the dose level for the next treatment period.
Pharmacogenomics and metabolomics exploratory studies are added as a sub-study to better
understand the underlying disease, its progression as well as the impact of ACE-inhibition
on cardiac outcome and renal function.
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Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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