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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
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 mavacamtenLocations (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
- Evanston, Illinois, United States
- Boston, Massachusetts, United States
- Boston, Massachusetts, United States
- Burlington, Massachusetts, United States
- Detroit, Michigan, United States
- Kansas City, Missouri, United States
- Morristown, New Jersey, United States
- New York, New York, United States
- Charlotte, North Carolina, United States
- Morrisville, North Carolina, United States
- 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
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