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Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Metoprolol Succinate in Adults With Symptomatic oHCM
Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Metoprolol Succinate in Adults With Symptomatic oHCM

NCT05767346

CompletedPhase 3

Sponsor: Cytokinetics

Conditions: Obstructive Hypertrophic Cardiomyopathy (oHCM)

Interventions: Aficamten (CK-3773274) (5 mg, 10 mg, 15 mg and 20 mg), Placebo to match aficamten, Metoprolol succinate (50 mg, 100 mg, 150 mg and 200 mg), Placebo to match metoprolol succinate

Countries: United States, Brazil, Canada, China, Denmark, France, Germany, Hungary

The purpose of this study is to compare the efficacy and safety of aficamten (CK-3773274) compared with metoprolol succinate in adults with symptomatic hypertrophic cardiomyopathy and left ventricular outflow tract obstruction

Eligibility overview

Sex: ALL

Age: 18 Years to 85 Years

Healthy volunteers: No

Study type: INTERVENTIONAL

Eligibility criteria
Inclusion Criteria:

* Participants who meet all the following criteria at screening may be included in the trial:

  * Males and females between 18 to 85 years of age, inclusive, at screening
  * Body mass index \< 35 kg/m2
  * Diagnosed with oHCM per the following criteria by cardiac magnetic resonance imaging (CMR) or echocardiography -

    * Has left ventricular (LV) hypertrophy with non-dilated LV chamber in the absence of other cardiac disease and
    * Has an end-diastolic LV wall thickness as measured by the echocardiography core laboratory:

      1. ≥ 15 mm in one or more myocardial segments OR
      2. ≥ 13 mm in one or more wall segments and a known disease-causing gene mutation or positive family history of HCM
  * New York Heart Association (NYHA) class II or III
  * Has a Kansas City Cardiomyopathy Questionnaire - Clinical Summary Score (KCCQ-CSS) score of ≤ 90 at screening
  * Has a screening echocardiogram with the following determined by the echocardiography core laboratory:

    * Resting left ventricular outflow tract gradient (LVOT-G) \> 30 mm Hg and/or post-Valsalva LVOT-G ≥ 50 mmHg at screening AND
    * LVEF ≥ 60%
  * Hemoglobin ≥ 10g/dL
  * Respiratory exchange ratio (RER) ≥ 1.05 and peak oxygen uptake (pVO2) \< 100% predicted on the screening cardiopulmonary exercise testing (CPET) per the core laboratory
  * Patients previously exposed to mavacamten are allowed to participate but must be off mavacamten for at least 8 weeks

Exclusion Criteria:

* Any of the following criteria will exclude potential participants from the trial:

  * Medical indication for either beta blocker or calcium-channel blockers prohibiting drug discontinuation other than oHCM
  * History of intolerance or medical contraindication to beta blocker therapy
  * Resting Systolic Blood Pressure (SBP) of \> 160 mmHg
  * Resting heart rate of \> 100 bpm
  * Significant valvular heart disease

    1. Moderate-severe valvular aortic stenosis or fixed subaortic obstruction
    2. Mitral regurgitation not due to systolic anterior motion of the mitral valve (per Investigator judgment)
  * Known or suspected infiltrative, genetic or storage disorder causing cardiac hypertrophy that mimics oHCM (eg, Noonan syndrome, Fabry disease, amyloidosis)
  * History of LV systolic dysfunction (LVEF \< 45%) or stress cardiomyopathy at any time during their clinical course
  * Inability to exercise on a treadmill or bicycle (eg, orthopedic limitations)
  * Documented room air oxygen saturation reading \< 90% at screening
  * Planned septal reduction treatment that cannot be deferred during the trial period
  * History of septal reduction therapy (surgical myectomy or alcohol septal ablation) within 6 months of screening
  * History of paroxysmal or persistent atrial fibrillation or atrial flutter. Atrial flutter treated with radio frequency ablation without recurrence within the last 6 months prior to screening is allowed.
  * Current or recent (\< 4 weeks) therapy with disopyramide
  * History of syncope, symptomatic ventricular arrhythmia, or sustained ventricular tachyarrhythmia with exercise within 6 months prior to screening
  * Has received prior treatment with aficamten or previously intolerant (reduced LVEF requiring permanent drug discontinuation) to mavacamten
Locations (71)
  • Anchorage, Alaska, United States
  • Phoenix, Arizona, United States
  • La Jolla, California, United States
  • Los Angeles, California, United States
  • New Haven, Connecticut, United States
  • Orlando, Florida, United States
  • Atlanta, Georgia, United States
  • Fayetteville, Georgia, United States
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  • Detroit, Michigan, United States
  • Kansas City, Missouri, United States
  • Morristown, New Jersey, United States
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  • Portland, Oregon, United States
  • Portland, Oregon, United States
  • Philadelphia, Pennsylvania, United States
  • Charleston, South Carolina, United States
  • Nashville, Tennessee, United States
  • Nashville, Tennessee, United States
  • Houston, Texas, United States
  • Houston, Texas, United States
  • Murray, Utah, United States
  • Falls Church, Virginia, United States
  • Campinas, São Paulo, Brazil
  • São Paulo, São Paulo, Brazil
  • + 41 more on CT.gov