Effect of pharmacological treatment with angiotensin receptor/neprilysin inhibitors on transthyretin cardiac amyloidosis and heart failure with reduced ejection fraction

2024-515661-34-00 Therapeutic use (Phase IV) Ongoing, recruiting

Start 27 Feb 2025 · Status Ongoing, recruiting · 1 EU/EEA countries · 9 sites

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Ongoing, recruiting
Participants planned 114
Countries 1
Sites 9

Transthyretin cardiac amyloidosis

The primary objective is to determine the impact of treatment with Sacubitril/Valsartan on systolic function in patients with transthyretin amyloid cardiomyopathy and heart failure with reduced ejection fraction, by assessing the change in left ventricular ejection fraction in echocardiogram at 12 months.

Key facts

Sponsor
Fundacion Para La Investigacion Biomedica Del Hospital Universitario Puerta De Hierro Majadahonda
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Cardiovascular Diseases [C14]
Trial duration
27 Feb 2025 → ongoing
Decision date (initial)
2024-10-24
Transition trial
No
Low-intervention
Yes
Rare-disease indication
Yes
Vulnerable population
No
Funding sources
Instituto de Salud Carlos III (PI23/01180)

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Safety, Efficacy, Therapy

The primary objective is to determine the impact of treatment with Sacubitril/Valsartan on systolic function in patients with transthyretin amyloid cardiomyopathy and heart failure with reduced ejection fraction, by assessing the change in left ventricular ejection fraction in echocardiogram at 12 months.

Conditions and MedDRA coding

Transthyretin cardiac amyloidosis

VersionLevelCodeTermSystem organ class
25.1 LLT 10087643 Transthyretin cardiac amyloidosis 100000004848

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 4

  1. Patients ≥ 18 years of age of both sexes.
  2. Patients diagnosed with transthyretin amyloid cardiomyopathy, both in its hereditary form (ATTRv) or wild-type form (ATTRwt). The diagnosis of ATTR will be based on histological demonstration of TTR amyloid deposition or non-invasive criteria as indicated in guidelines. For ATTRv diagnosis, demonstration of causal TTR mutation through genetic testing will be required.
  3. Patients initially evaluated or under follow-up in Cardiomyopathy/Heart Failure/Amyloidosis Units at participating centers.
  4. Presenting with heart failure and reduced ejection fraction: LVEF ≤45%, in functional class I, II, or III according to the New York Heart Association (NYHA).

Exclusion criteria 9

  1. NYHA Functional Class IV.
  2. Stage 4 and 5 chronic kidney disease (creatinine clearance by CKD-EPI <30 mL/min/1.73m²).
  3. Hyperkalemia (blood potassium levels > 5.4 mmol/L).
  4. Hypotension defined as systolic blood pressure <100 mmHg on two consecutive measurements.
  5. Treatment with ACE inhibitors (IECA), angiotensin II receptor blockers (ARAII), or sacubitril/valsartan at the time of enrollment.
  6. History of angioedema or hypersensitivity to ACE inhibitors or angiotensin II receptor blockers.
  7. Treatment with diflunisal.
  8. Participation in another clinical trial or any condition that, in the investigator's opinion, compromises participation in the study.
  9. Pregnancy, breastfeeding, or fertile women unwilling to use adequate contraception throughout the study duration.

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Change in left ventricular ejection fraction (%), assessed by echocardiogram, compared to baseline value after 12-month treatment with Sacubitrl/Valsartan versus management without Sacubitril/Valsartan. An improvement in left ventricular ejection fraction will be defined as an increase of ≥ 5% between the baseline echocardiogram and the 12-month echocardiogram.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Entresto 24 mg/26 mg film-coated tablets

PRD3417298 · Product

Active substance
Valsartan
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL
Max daily dose
194 mg milligram(s)
Max total dose
70810 mg milligram(s)
Max treatment duration
12 Month(s)
Authorisation status
Authorised
ATC code
C09DX04 — -
Marketing authorisation
EU/1/15/1058/001
MA holder
NOVARTIS EUROPHARM LIMITED
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Fundacion Para La Investigacion Biomedica Del Hospital Universitario Puerta De Hierro Majadahonda

5 Total trials 5 Recruiting
Academic / Non-commercial
Sponsor organisation
Fundacion Para La Investigacion Biomedica Del Hospital Universitario Puerta De Hierro Majadahonda
Address
Calle De Joaquin Rodrigo 2
City
Majadahonda
Postcode
28222
Country
Spain

Scientific contact point

Organisation
Fundacion Para La Investigacion Biomedica Del Hospital Universitario Puerta De Hierro Majadahonda
Contact name
Cristina Avendaño Solá

Public contact point

Organisation
Fundacion Para La Investigacion Biomedica Del Hospital Universitario Puerta De Hierro Majadahonda
Contact name
Cristina Avendaño Solá

Locations

1 EU/EEA country · 9 investigational sites

By country

CountryMS statusPlanned subjectsSites
Spain Ongoing, recruiting 114 9
Rest of world 0

Investigational sites

Spain

9 sites · Ongoing, recruiting
Complexo Hospitalario Universitario A Coruna
Cardiology, Lugar Jubias De Arriba 84, 15006, A Coruna
Hospital Clinic De Barcelona
Cardiology, Calle Villarroel 170, 08036, Barcelona
Hospital Clinico Universitario Lozano Blesa
Internal Medicine, Avenida De San Juan Bosco 15, 50009, Zaragoza
Hospital General Universitario De Ciudad Real
Flores, Calle Del Obispo Rafael Torija S/n, 13005, Ciudad Real
Hospital Universitario De Salamanca
Cardiology, Paseo De San Vicente 58-182, 37007, Salamanca
Hospital Universitario Puerta De Hierro De Majadahonda
Cardiology, Calle De Manuel De Falla 1, 28222, Majadahonda
Bellvitge University Hospital
Cardiology, Carrer De La Feixa Llarga S/N, 08907, L'Hospitalet De Llobregat
Hospital Universitario Donostia
Cardiology, Pasealeku Doct. Begiristain 109, 20014, Donostia
Complexo Hospitalario Universitario De Santiago
Cardiology, Calle Choupana Da S/n, 15706, Santiago De Compostela

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Spain 2025-02-27 2025-10-13

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 10 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol 2024-515661-34-00 1
Protocol (for publication) D1_protocol ES 2024-515661-34-00 V2 2
Protocol (for publication) Protocol TC V2 1
Recruitment arrangements (for publication) K1_Recruitment arrangement 1
Subject information and informed consent form (for publication) L1_HIP y CI_version1_sep2024 1
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC sacubitrilvalsartan 1
Synopsis of the protocol (for publication) D1_Protocol synopsis ENG 2024-515661-34-00 1
Synopsis of the protocol (for publication) D1_Protocol synopsis ENG 2024-515661-34-00 v2 2
Synopsis of the protocol (for publication) D1_Protocol synopsis_ESP 2024-515661-34-00 1
Synopsis of the protocol (for publication) D1_Protocol synopsis_ESP 2024-515661-34-00 v2 2

Application history

3 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-09-02 Spain Acceptable
2024-10-23
2024-10-24
2 SUBSTANTIAL MODIFICATION SM-1 2025-12-19 Spain Acceptable
2026-03-06
2026-03-10
3 SUBSTANTIAL MODIFICATION SM-2 2026-03-10 Spain Acceptable 2026-04-13