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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT01966887
Other study ID # P081252
Secondary ID
Status Terminated
Phase Phase 2
First received September 26, 2013
Last updated August 28, 2017
Start date December 2013
Est. completion date February 2016

Study information

Verified date August 2017
Source Assistance Publique - Hôpitaux de Paris
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to determine the effect of intracoronary SERCA2a Gene transfer on cardiac volumes and function using multimodality cardiac imaging.


Description:

The purpose of gene transfer of SERCA2a is to improve systolic and diastolic function of the failing ventricle. Studies show that reduction of SERCA2a in failing ventricle is a key factor in depression of contraction, and that restoration of SERCA2a levels can improve left ventricular function and remodeling. The aim of the study is to investigate the effect of an adeno-associated viral vector expressing the sarcoplasmic reticulum calcium ATPase (SERCA2a), driven by the CMV promoter (AAV1-CMV-SERCA2a), on the ventricular remodeling of patients with severe heart failure using multimodality cardiac imaging. This is a Phase 2 monocenter double blind randomized placebo-controled, parallel study. The study will enroll 44 symptomatic heart failure patients with NYHA IIIb/IV, with left-ventricular ejection fraction of 35% or less receiving an optimal standard medical therapy. The absence of neutralizing antibodies against AAV1 will be primarily checked. Seronegative patients will be randomized to receive either 1x10e13 AAV1-CMV-Serca2a or a placebo as a single intracoronary infusion. Evolution during the next 6 months of the left ventricular end-systolic volume (measured with a 256-slices CT-scan before injection and 6 months later) will be the primary endpoint. Secondary endpoints will include changes in the LVEF, diastolic volumes, VO2max, Echocardiographic remodeling, BNP, cardiac hemodynamics and biological safety profile.


Recruitment information / eligibility

Status Terminated
Enrollment 10
Est. completion date February 2016
Est. primary completion date September 2015
Accepts healthy volunteers No
Gender All
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria:

- Patients with NYHA class III / IV severe heart failure = 3 months

- Ischemic or non-ischemic origin

- Left ventricular ejection fraction =35%

- Patients must be receiving optimal (maximum tolerated doses) medical treatment (diuretics, renin-angiotensin-aldosterone system blockers, beta blockers, ±Ivabradine) for at least 1 month (with the exception of diuretic dose titration) and must be stable.

- No decompensated congestive heart failure within the past month

- With or without an ICD if the ICD was implanted over 3 months ago, with or without biventricular pacing if the RCT was implanted over 6 months ago

- All women of childbearing potential must have a negative urine pregnancy test prior to administration of investigational medicinal product

- Patient must have given written informed consent to participate in this study

Exclusion Criteria:

- <18 or >80 years old

- AAV1 seropositivity (titer <1:2) in the last 3 months

- Atrial fibrillation in the absence of permanent ventricular pacing

- Coronary revascularization or heart surgery or pacemaker implantation < 3 months

- Ischemic heart disease without at least one coronary artery with a TIMI-3 flow

- Restrictive cardiomyopathy, hypertrophic obstructive cardiomyopathy, pericardial disease, cardiac amyloidosis

- Heart transplant, an already implanted or needing to urgently implant external ventricular assist device

- Myocardial infarction (STEMI or NSTEMI) < 3 months

- Treatment with intravenous positive inotropic agents or diuretics in the past 28 days

- Pregnant or nursing patient

- Female patient of childbearing age with no effective means of contraception

- Severe renal failure defined by a creatinine clearance of < 30 mL/min (last bloodwork done less than 6 months)

- Liver failure, chronic liver disease or laboratory tests > 3 x N (AST, ALT, ALP))(last bloodwork done less than 6 months)

- Thrombocytopenia (<50,000/mm3

- Patient treated with immunosuppressants, has an immunodeficiency or whose neutrophil count < 1000 mm3

- Recent sepsis (< 3 months)

- Active neoplasia or treated < 5 years

- No medical insurance

- Patient is enrolled in another randomized study

- Patient does not understand the protocol procedures sponsor suspects poor compliance with the protocol

Study Design


Intervention

Genetic:
MYDICAR-single intracoronary infusion
AAV1/Serca2a
Placebo; single intracoronary infusion
single intracoronary infusion

Locations

Country Name City State
France CHU Pitié-Salpêtrière Paris

Sponsors (2)

Lead Sponsor Collaborator
Assistance Publique - Hôpitaux de Paris Celladon Corporation

Country where clinical trial is conducted

France, 

References & Publications (1)

Hulot JS, Salem JE, Redheuil A, Collet JP, Varnous S, Jourdain P, Logeart D, Gandjbakhch E, Bernard C, Hatem SN, Isnard R, Cluzel P, Le Feuvre C, Leprince P, Hammoudi N, Lemoine FM, Klatzmann D, Vicaut E, Komajda M, Montalescot G, Lompré AM, Hajjar RJ; AG — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary left ventricular end-systolic volume measured by CT-Scan left ventricular end-systolic volume measured by CT-Scan / changes from baseline to 6 months at 6 months
Secondary CT-scan other measurments: left ventricular end-diastolic volume CT-scan other measurments: left ventricular end-diastolic volume / changes from baseline to 6 and 12 months at 6 and 12 months
Secondary Cardiac volumes and function Cardiac volumes and function / changes from baseline to 6 months & 12 months at 6 and 12 months
Secondary Cardiac hemodynamic parameters Cardiac hemodynamic parameters; changes from baseline to 6 months at 6 months
Secondary VO2 max VO2 max; changes from baseline to 6 months and 12 months at 6 and 12 months
Secondary Cardiac function assessed by echocardiography Changes from baseline to 6 and12 months in:Echocardiographic assessments at 6 and12 months
Secondary Quality of Life (Kansas city score) Changes from baseline to 3,6,9,12 months in:Quality of Life at 3,6,9,12 months
Secondary NT-ProBNP Changes from baseline to 6 and12 months in:NT-ProBNP at 6 and12 months
Secondary Time to cardiovascular event Time to cardiovascular event (all-cause death, heart transplant, LVAD implantation) - administration to 12 months at 6 and 12 months
Secondary Number of hospitalized patients for worsening heart failure at 6 and 12 months
Secondary Cardiac volumes assessed by echocardiography Changes from baseline to 6 and12 months in:Echocardiographic assessments at 6 and12 months
Secondary CT-scan other measurments: left ventricular end-systolic volume CT-scan other measurments: left ventricular end-systolic volume / changes from baseline to 12 months 12 months
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