PHOspholamban RElated CArdiomyopathy STudy - Intervention (i-PHORECAST)

This study is not yet open for participant recruitment.
Verified May 2013 by University Medical Centre Groningen
Sponsor:
Collaborators:
Netherlands: TCC, Trial Coordination Center UMCG
The Interuniversity Cardiology Institute of the Netherlands
ZonMw: The Netherlands Organisation for Health Research and Development
Netherlands: CVON, CardioVascular Research Netherlands
Information provided by (Responsible Party):
M.p. van den Berg, MD, PhD, professor in Cardiology, University Medical Centre Groningen
ClinicalTrials.gov Identifier:
NCT01857856
First received: May 8, 2013
Last updated: May 15, 2013
Last verified: May 2013

May 8, 2013
May 15, 2013
September 2013
September 2017   (final data collection date for primary outcome measure)
  • LV enddiastolic volume, increase >10%, as measured by MRI [ Time Frame: three years ] [ Designated as safety issue: No ]
  • LV ejection fraction, absolute decrease >5%, as measured by MRI [ Time Frame: three years ] [ Designated as safety issue: No ]
  • RV enddiastolic volume, increase >10%, as measured by MRI [ Time Frame: three years ] [ Designated as safety issue: No ]
  • RV ejection fraction, absolute decrease >5%, as measured by MRI [ Time Frame: three years ] [ Designated as safety issue: No ]
  • late gadolinium enhancement, absolute increase >5%, as measured by MRI [ Time Frame: three years ] [ Designated as safety issue: No ]
  • Change in ventricular premature complexes, increase >100% in combination with absolute number >1000/24 hrs (Holter monitoring) [ Time Frame: yearly at 0, 1, 2 and 3 years ] [ Designated as safety issue: No ]
  • Change in the occurrence of non-sustained ventricular tachycardia (Holter monitoring, exercise testing) [ Time Frame: yearly at 0, 1, 2 and 3 years ] [ Designated as safety issue: No ]
  • Change in QRS voltage, decrease >25% (ECG) [ Time Frame: yearly at 0,1,2 and 3 years ] [ Designated as safety issue: No ]
  • Change in symptoms/signs of heart failure and/or arrhythmias necessitating treatment according to the attending physician and likely due to arrhythmogenic cardiomyopathy [ Time Frame: yearly at 0,1,2 and 3 years, and possibly in between at referral ] [ Designated as safety issue: No ]
  • (Change in) cardiovascular death, including sudden death, likely due to arrhythmogenic cardiomyopathy [ Time Frame: yearly at 0,1,2 and 3 years, and possibly in between at referral ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT01857856 on ClinicalTrials.gov Archive Site
  • Change in biomarkers [ Time Frame: yearly at 0, 1, 2 and 3 years ] [ Designated as safety issue: No ]
  • Change in QRS-axis on 12-lead ECG [ Time Frame: yearly at 0,1, 2 and 3 years ] [ Designated as safety issue: No ]
  • Change in conduction intervals (PR-interval, QRS-duration) on 12-lead ECG and SA-ECG [ Time Frame: yearly at 0,1, 2 and 3 years ] [ Designated as safety issue: No ]
  • Change in STT-segment on 12-lead ECG [ Time Frame: yearly at 0,1, 2 and 3 years ] [ Designated as safety issue: No ]
  • Development of global or regional dysfunction and structural alterations on MRI [ Time Frame: three years ] [ Designated as safety issue: No ]
  • (Change in) Diagnosis of ARVC (according to task force criteria) [ Time Frame: yearly at 0,1,2 and 3 years, and possibly in between at referral ] [ Designated as safety issue: No ]
  • (Change in) Diagnosis of DCM [ Time Frame: yearly at 0,1,2 and 3 years, and possibly in between at referral ] [ Designated as safety issue: No ]
  • Change in occurrence of sustained ventricular tachycardia or ventricular fibrillation [ Time Frame: yearly at 0,1,2 and 3 years, and possibly in between at referral ] [ Designated as safety issue: No ]
  • (Change in) hospitalization for a cardiovascular reason [ Time Frame: yearly at 0,1,2 and 3 years, and possibly in between at referral ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
PHOspholamban RElated CArdiomyopathy STudy - Intervention
PHOspholamban RElated CArdiomyopathy STudy - Intervention (Efficacy Study of Eplerenone in Presymptomatic PLN-R14del Carriers)

In the Netherlands ≈15% of idiopathic dilated cardiomyopathy (DCM) and ≈10% arrhythmogenic right ventricular cardiomyopathy (ARVC) patients carry a single (founder) mutation in the gene encoding Phospholamban, PLN R14del. Analogous to other inherited cardiomyopathies, the natural course of the disease is age-related ("age-related penetrance"); after a presymptomatic phase of variable length many PLN R14del-carriers progress to overt disease, and are diagnosed with either DCM or ARVC. PLN is a regulator of the sarcoplasmic reticulum Ca2+-ATPase (SERCA2a) pump in cardiac muscle and thereby important for maintaining Ca2+ homeostasis. Cardiac fibrosis appears to be an early manifestation of disease. The investigators hypothesize that treatment of presymptomatic PLN R14del-carriers with eplerenone, which by virtue of its mineralocorticoid(aldosterone)-blocking properties is a strong antifibrotic agent, reduces disease progression and postpones onset of overt disease.

Not Provided
Interventional
Phase 3
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Phospholamban Related Cardiomyopathy
Drug: Eplerenone
Other Name: Inspra
  • No Intervention: No intervention
    no intervention
  • Active Comparator: Eplerenone
    Eplerenone (Inspra, 50 mg for 3 years once daily) oral, film-coated tablet 50 mg for 3 years once daily
    Intervention: Drug: Eplerenone
van der Zwaag PA, van Rijsingen IA, Asimaki A, Jongbloed JD, van Veldhuisen DJ, Wiesfeld AC, Cox MG, van Lochem LT, de Boer RA, Hofstra RM, Christiaans I, van Spaendonck-Zwarts KY, Lekanne dit Deprez RH, Judge DP, Calkins H, Suurmeijer AJ, Hauer RN, Saffitz JE, Wilde AA, van den Berg MP, van Tintelen JP. Phospholamban R14del mutation in patients diagnosed with dilated cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy: evidence supporting the concept of arrhythmogenic cardiomyopathy. Eur J Heart Fail. 2012 Nov;14(11):1199-207. doi: 10.1093/eurjhf/hfs119. Epub 2012 Jul 20.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Not yet recruiting
150
Not Provided
September 2017   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • PLN R14del mutation carriers
  • Age ≥18 and ≤ 65 years
  • New York Heart Association functional class ≤ 1
  • LV ejection fraction ≥.45 (measured with MRI)

Exclusion Criteria:

  • Palpitations necessitating treatment (at the discretion of the attending physician)
  • A diagnosis of DCM (see appendix 1). Note: regional LV wall motions abnormalities are acceptable.
  • A diagnosis of ARVC (according to the task force criteria, see appendix 2)
  • Global or regional RV dysfunction and/or structural alterations (according to task force criterion 1, see appendix 2).
  • Ventricular premature complexes >1000 during 24hours Holter-monitoring
  • Non-sustained ventricular tachycardia during Holter-monitoring or exercise-testing
  • History of sustained ventricular tachycardia or ventricular fibrillation
  • Hypertension requiring the use of antihypertensive drugs, or when this is anticipated within the coming 3 years
  • Evidence of ischemic heart disease
  • Treatment with cardioactive medication
  • Hyperkaliemia (serum potassium >5.0 mmol/l)
  • Severe renal dysfunction (eGFR <30 ml/min/kg)
  • Severe hepatic impairment (Child-Pugh class C)
  • Women who are currently pregnant or report a recent pregnancy (last 60 days) or plan on becoming pregnant.
  • Concomitant use of strong CYP3A4-inhibitors
  • Concomitant chronic use of NSAIDs
  • Known intolerance or contraindication to aldosterone antagonists
  • Participation in another drug trial in which the last dose of drug was within the past 30 days.
  • Contra-indications for MRI (claustrophobia, metal devices)
  • Subjects unable or unwilling to provide written informed consent Note: presence of late gadolinium enhancement on MRI is not an exclusion criterion
Both
18 Years to 65 Years
No
Contact: Maarten van den Berg, MD PhD 0031503612355 m.p.van.den.berg@umcg.nl
Contact: Wouter te Rijdt, MD 0031503615385 w.p.te.rijdt@umcg.nl
Netherlands
 
NCT01857856
TCC2012007, 2013-001067-23
Yes
M.p. van den Berg, MD, PhD, professor in Cardiology, University Medical Centre Groningen
M.p. van den Berg, MD, PhD, professor in Cardiology
  • Netherlands: TCC, Trial Coordination Center UMCG
  • The Interuniversity Cardiology Institute of the Netherlands
  • ZonMw: The Netherlands Organisation for Health Research and Development
  • Netherlands: CVON, CardioVascular Research Netherlands
Principal Investigator: Maarten van den Berg, MD PhD UMCG, Department of Cardiology
University Medical Centre Groningen
May 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP