Heart Failure Clinical Trial
Official title:
Orodispersible Minitablets of Enalapril in Young Children With Heart Failure Due to Congenital Heart Disease
Paediatric clinical trial in 50 children, from newborn to less than 6 years of age, suffering from heart failure due to congenital heart disease, 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 to Adolescents) project: 50 children with heart
failure due to congenital heart disease (LENA-Work Package (WP)09 Trial), and 50 children
with heart failure due to dilated cardiomyopathy (LENA-WP08 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 WP09 Trial children from age of newborn to less than 6 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 level 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 a target dose similar to
the adult target dose (20 mg 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 strength 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 the
ACE-inhibition on cardiac outcome and renal function.
;
Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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