To investigate whether the extent of myocardial αvβ3 expression visualized by imaging with 99mTc -NC100692 Injection can be used as a surrogate endpoint for the outcome of therapeutic interventions, using standard and novel treatments (ACE-…
ID
Source
Brief title
Condition
- Heart failures
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
• To investigate whether the extent of αvβ3 expression at 3 or 8 weeks after
MI, or the difference between the amount of tracter uptake at 3 and 8 weeks,
can be used as a surrogate endpoint for therapeutic interventions, using
existing and novel treatments (ACE-I vs. ACE-I+eplerenone).
• Ejection fraction based on cMRI will be used as endpoint for the effect of
therapeutic interventions on cardiac function, and the relation between αvβ3
expression at 3 or 8 weeks after MI and EF (endpoint) will be examined.
Secondary outcome
Not applicable
Background summary
Heart failure (HF) is an increasing problem in the global population with a
current prevalence in the Netherlands of approximately 165.000 patients.
Myocardial infarction (MI) is the main cardiac insult leading to HF. Following
MI, the development of clinically symptomatic HF is a relatively slow process,
taking months to years. Development of HF is characterised by continuous
remodelling of the heart during which contractile function is progressively
lost. The remodelling process involves cardiomyocyte hypertrophy, fibrosis,
extracellular matrix (collagen) deposition and alterations in cardiac gene
expression. The amount of remodeling tissue is of immense importance for
prediction of the patients' outcome.
Study objective
To investigate whether the extent of myocardial αvβ3 expression visualized by
imaging with 99mTc -NC100692 Injection can be used as a surrogate endpoint for
the outcome of therapeutic interventions, using standard and novel treatments
(ACE-I vs. ACE-I+eplerenone).
Study design
This is a phase 2b, double-blinded, randomized study and is the second study
within the indication of HF development in post-MI subjects. The study aims to
determine whether the extent of myocardial αvβ3 expression delineated by
99mTc-NC100692 Injection scintigraphy imaging at 3 and 8 weeks after MI can be
used as a surrogate endpoint for the outcome of therapeutic interventions,
using existing and novel treatments (ACE-I vs. ACE-I+eplerenone).
Intervention
All subjects will receive administration of 99mTc-NC100692 Injection at
nominally 3 and 8 weeks after MI and undergo SPECT/CT imaging.
Patients will recieve standard medication (ACE-I, n=41), ACE-I & eplerenone
(50 mg/dag, n=41).
Study burden and risks
The patients will receive physical examination according to the hospital's
routines for patients with MI. A pregnancy test will be performed. The patients
will receive 2 injections with 99mTc-NC100692. Although there is a small
theoretical health risk associated with this additional radiation dose, the
overall safety profile of radionuclide imaging agents such as 99mTc-NC100692
Injection is extremely good. Overall, 99mTc-NC100692 Injection has been
demonstrated to be safe and well tolerated in a total of 81 subjects. The
advantage of creating an early therapeutic endpoint with 99mTc-NC100692
Injection will greatly accelerate the development of new therapies to fight
heart failure. Taken together, in our opinion, the small radiation dose used in
this study is justified.
Universiteitssingel 50
6229 ER Maastricht
Nederland
Universiteitssingel 50
6229 ER Maastricht
Nederland
Listed location countries
Age
Inclusion criteria
(1) The subject has had no previous MI (a previous MI/scar could potentially result in tracer uptake and therefore interfere with the imaging outcome), presents with acute MI and has undergone coronary angiography during which percutaneous coronary intervention (PCI) or no intervention may be performed. The documentation of coronary anatomy and disease will be linked to the imaging outcome.;(2) The subject is >=35 years of age at study entry. Maximum age is 80 years, provided patients are in good medical condition.;(3) The subject is able and willing to comply with study procedures and signed and dated informed consent is obtained, including permission to access coronary angiography records (see inclusion criterion No. 1), before any study procedure is carried out. ;(4) The subject is male, or a female who is either surgically sterile (has had a documented bilateral oophorectomy and/or documented hysterectomy), sterilized by tubaligation, postmenopausal (cessation of menses for more than 1 year), non-lactating, or of childbearing potential for whom the result of a urine pregnancy test performed before administration of 99mTc-NC100692 Injection is negative, to prevent potential harm to the potentially present unborn foetus.;(5) The subject has been clinically stable (e.g., not experiencing continuing chest pain or haemodynamic instability) for at least 7 days before each imaging session with 99mTcNC100692 Injection*. (An unstable patient would be put to risk unnecessarily if subjected to an imaging study and will therefore be excluded.);(6) The subject has an LVEF of >=40% and <=55% and is NYHA class 1-2: Patients with EF below 40% have to receive spironolactone/eplerenone according to the guidelines. In patients with EF above 55%, the infarct will be too small for significant tracer uptake.;* This inclusion criterion will be checked at 3 and 8 weeks post-MI.
Exclusion criteria
(1) The subject was previously entered into this study or has participated in any other IMP study within 30 days of study entry, since this could interfere with the medications tested.;(2) The subject is scheduled to receive another IMP from time of entry into this study until completion of the follow-up period after the second injection proposed for this study, since this could interfere with the medications and endpoints tested.;(3) The subject has known allergies to any product used in this study or its constituents (e.g., para-amino benzoic acid). ;(4) The subject undergoes monitoring of occupational radiation exposure. ;(5) The subject presents with any other clinically active, serious, life-threatening disease and has a life expectancy of less than 12 months, where participation in the study might compromise the management of the subject, or for any other reason that in the judgement of the investigators makes the subject unsuitable for participation in the study. ;(6) The subject is scheduled to have a revascularisation procedure (e.g., PCI or CABG) in the 30 days after study entry or cardiac transplantion. ;(7) The subject participated in a research study using ionising radiation within 12 months of study entry, to prevent the patients receiving more than the maximal recommended yearly exposure to ionizing radiation.
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2009-010608-27-NL |
CCMO | NL25886.068.09 |