Evaluation of RLY5016 in Heart Failure Patients (PEARL-HF)

This study has been completed.
Medpace, Inc.
Information provided by (Responsible Party):
Relypsa, Inc.
ClinicalTrials.gov Identifier:
First received: March 23, 2009
Last updated: November 3, 2014
Last verified: November 2014
The purpose of this study is to assess the effects of RLY5016 on serum potassium in heart failure patients. This study will also assess the safety and tolerability of RLY5016 in heart failure patients.

Condition Intervention Phase
Heart Failure
Drug: Spironolactone + RLY5016
Drug: Spironolactone + Placebo
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: A Multicenter, Randomized, Double-blind, Placebo-Controlled, Parallel-Group, Multiple-Dose Study to Evaluate the Effects of RLY5016 in Heart Failure Patients

Resource links provided by NLM:

Further study details as provided by Relypsa, Inc.:

Primary Outcome Measures:
  • Change from baseline in serum potassium [ Time Frame: 28 days ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Safety and tolerability [ Time Frame: 28 days ] [ Designated as safety issue: Yes ]

Enrollment: 105
Study Start Date: April 2009
Study Completion Date: December 2009
Primary Completion Date: November 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: RLY5016 Drug: Spironolactone + RLY5016
Active investigational drug
Placebo Comparator: Placebo Drug: Spironolactone + Placebo

Detailed Description:

Double-blind, randomized, placebo-controlled, parallel-group, multiple-dose study in up to 270 congestive heart failure patients. Depending on the outcome from the initial cohort of 100 patients (Part 1), a second cohort of 170 patients may be enrolled (Part 2).

Part 1:

One hundred eligible patients will be randomly assigned to receive RLY5016 (30 g/day) or placebo for 28 days. All patients will also receive spironolactone; the initial spironolactone dose is 25 mg daily and will be increased to 50 mg daily for patients who have a serum potassium ≤ 5.1 mEq/L on treatment Day 14. Study visits will be scheduled for treatment Days 3, 7, 14, 17, 21 and 28.

A safety follow-up contact will be made 7 days after administration of last dose of study drug.

An interim analysis will be conducted after data from Part 1 are available.

Part 2:

One hundred seventy eligible patients will be randomly assigned to one of two RLY5016 treatment groups (15 or 60 g/day) or placebo for 28 days. All patients will also receive spironolactone for 28 days; the initial spironolactone dose is 25 mg daily and will be increased to 50 mg daily for patients who have a serum potassium ≤ 5.1 mEq/L on treatment Day 14. Study visits will be scheduled for treatment Days 3, 7, 14, 17, 21 and 28.

A safety follow-up contact will be made 7 days after administration of last dose of study drug.


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Heart failure patients clinically indicated to receive spironolactone therapy, with serum potassium levels of 4.3 - 5.1 mEq/L AND chronic kidney disease (GFR <60 mL/min) OR documented history of hyperkalemia within the last 6 months
  • Females of child-bearing potential must be non-lactating, must have a negative serum pregnancy test at screening, and must have used a highly effective form of contraception for at least 3 months before study drug administration, during the study, and for one month after study completion
  • Male patients and/or their female partners of child-bearing potential must use a highly effective form of contraception during the study and for 3 months after study completion
  • Must sign informed consent document

Exclusion Criteria:

  • History of bowel obstruction, swallowing disorders, severe gastrointestinal disorders or major gastrointestinal surgery
  • Uncorrected hemodynamically significant primary valvular disease, known obstructive or restrictive cardiomyopathy, uncontrolled or hemodynamically unstable arrhythmia
  • Coronary-artery bypass graft, percutaneous intervention (e.g. cardiac, cerebrovascular, aortic), or major surgery including thoracic and cardiac, within 3 months prior to baseline or anticipated need during study participation
  • Heart transplant recipient, or anticipated need for transplant during study participation
  • Any of the following events having occurred within 3 months prior to baseline: unstable angina as judged by the Investigator, unresolved acute coronary syndrome, transient ischemic attack or stroke
  • Current dialysis patient, or anticipated need for dialysis during study participation
  • Prior kidney transplant, or anticipated need for transplant during study participation
  • Metastatic, late-stage or end-stage cancer with < 12 months life expectancy
  • History of alcoholism or drug/chemical abuse within 1 year
  • QTcB interval > 500 msec (Bazett's correction formula)
  • Sustained systolic blood pressure > 170 or < 90 mmHg
  • Liver enzymes (ALT, AST) > 3 times upper limit of normal
  • Use of oral cardiac medications (including loop and thiazide diuretics) that have not been stable for at least 21 days prior to baseline and are not anticipated to remain stable during study participation
  • Use of any IV cardiac medications within 21 days prior to baseline, or their anticipated need during study participation.
  • Current use of polymer-based drugs (e.g. Renagel, Kayexalate, Welchol, Colestid), other phosphate binders or potassium binders, calcium supplements, antacids (eg TUMS, Maalox), or their anticipated need during study participation
  • Use of aldosterone antagonist in the last 30 days prior to baseline, unless was discontinued due to hyperkalemia
  • Use of potassium sparing medication and/or potassium supplements in the last 30 days prior to baseline
  • Use of any investigational medication, 30 days or 5 half-lives whichever is longer, prior to baseline
  • Patients who have taken investigational product in this study, or a previous RLY5016 study
  • Inability to consume the study medication, or, in the opinion of the Investigator, inability to comply with the protocol
  • In the opinion of the Investigator, any medical condition, uncontrolled systemic disease, serious intercurrent illness, or extenuating circumstance occurring or persisting, within 30 days prior to baseline, that would significantly decrease study compliance or jeopardize the safety of the patient or affect the validity of the trial results
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00868439

  Hide Study Locations
United States, California
Sutter Transplant Heart Specialty Clinic
Sacramento, California, United States, 95819
United States, Florida
University of Florida Health Science Center at Jacksonville
Jacksonville, Florida, United States, 32209
South Florida Research Group LLC
Miami, Florida, United States, 33176
Charlotte Cardiovascular Institute
Port Charlotte, Florida, United States, 33952
Brevard Cardiovascular Research Associates
Rockledge, Florida, United States, 32955
Florida Cardiovascular Institute
Tampa, Florida, United States, 33609
United States, Georgia
WellStar Cardiovascular Medicine
Marietta, Georgia, United States, 30060
United States, Illinois
Methodist Medical Group Cardiology
Peoria, Illinois, United States, 61606
United States, Maine
Southern Maine Medical Center PrimeCare Physician Services
Biddeford, Maine, United States, 04005
United States, Minnesota
Minneapolis VA Medical Center
Minneapolis, Minnesota, United States, 55417
United States, New Jersey
The Valley Hospital
Ridgewood, New Jersey, United States, 07450
United States, New York
Buffalo Heart Group
Buffalo, New York, United States, 14215
Northport VAMC Medical Services
Northport, New York, United States, 11768
University of Rochester Medical Center
Rochester, New York, United States, 14642
United States, Ohio
University of Cincinatti
Cincinatti, Ohio, United States, 45267
Lindner Center for Research and Education at the Christ Hospital
Cincinnati, Ohio, United States, 45219
Davis Heart & Lung Research Institute
Columbus, Ohio, United States, 43210
Greater Cincinatti Cardiovascular Consultants, Inc
Fairfield, Ohio, United States, 45014
United States, Pennsylvania
Hahnemann University Hospital / Tenet
Philadelphia, Pennsylvania, United States, 19102
Allegheny General Hospital
Pittsburgh, Pennsylvania, United States, 15212
United States, Rhode Island
Memorial Hospital of Rhode Island
Pawtucket, Rhode Island, United States, 02860
United States, Tennessee
The Stern Cardiovascular Center, PA
Germantown, Tennessee, United States, 38136
United States, Texas
VA North Texas Health Care Clinic
Dallas, Texas, United States, 75216
United States, Utah
Heart Center
Salt Lake City, Utah, United States, 84124
United States, Wisconsin
University of Wisconsin Hospital and Clinics
Madison, Wisconsin, United States, 53792
Czech Republic
Faculty Hospital, Internal Cardiology Clinic,
Brno, Czech Republic, 62500
Faculty Hospital Hradec Králové
Hradec Králové, Czech Republic, 500 05
Interni Klinika Kardiologie a Angiologie
Prague, Czech Republic, 12800
Klinika Kardiologie IKEM
Prague, Czech Republic, 14059
Multiprofile Clinical Hospital of Tblisi #2, LTD
Tblisi, Georgia, 0164
Diagnostic Services Clinic LTD
Tblisi, Georgia, 0179
EOPL Tbilisi State Medical University Alexandre Aladashvili University Clinic
Tblisi, Georgia, 0102
JSC National Center of Therapy
Tblisi, Georgia, 0159
Cardio-Reaninmation Centre LTD
Tblisi, Georgia, 0141
Charite - Universitatsmedizen Berlin
Berlin, Germany, D-13353
Kardiologie Klinik J.W Goethe Universitat
Frankfurt, Germany, 60590
University of Goettingen Georg-August-Universitaet Kardiologie und Pneumologie
Goettingen, Germany, 37075
Kardiologische Schwerpunktprxis
Heidelberg, Germany, 69120
Department of Cardiology, Medical Univeristy of Lodz
Lodz, Poland, 91-425
Katedra i Klinika Kardiologii
Lublin, Poland, 20-954
Instytut Kardiologii II, Klinika Choroby Wiencowej
Warsaw, Poland, 02637
Russian Federation
Municipal Healthcare Institution - City Hospital #1
Barnaul, Russian Federation, 656099
Municipal Healthcare Institute Kemerovo Cardiology Dispensary
Kemerovo, Russian Federation, 650002
Federal State Institution Outpatient Clinic #3
Moscow, Russian Federation, 129090
Federal State Institution Research Institute of Physical & Chemical Medicine of Roszdraz
Moscow, Russian Federation, 111020
State Healthcare Institution of Moscow - City Hospital #15
Moscow, Russian Federation, 111539
State Healthcare Institution of Moscow City Hospital #40
Moscow, Russian Federation, 129301
Federal Centre of heart, blood, endocrinology n.a. Almazov
St Petersburg, Russian Federation, 197341
St Petersburg State Healthcare Institution, City Hospital #15
St Petersburg, Russian Federation, 198205
St Petersburg State Healthcare Institution, Pokrovskaya City Hospital
St Petersburg, Russian Federation, 199106
State Institution Scientific Research Institute of Cardiology Tomsk
Tomsk, Russian Federation, 634012
Dnipropetrovsk City Clinical Hospital No. 9 Cardiology Department
Dnipropetrovsk, Ukraine, 49023
City Clinical Emergency Hospital, Therapy Department
Kharkiv, Ukraine, 61018
Kharkiv City Clinical Hospital No. 8, Department of Cardiology and Functional Diagnostics
Kharkiv, Ukraine, 61176
Malaya Institute of Therapy, AMS of Ukraine
Kharkiv, Ukraine, 61039
Institute of Gerontology, AMS of Ukraine
Kiev, Ukraine, 04114
National Medical University O.O. Bogomolets
Kiev, Ukraine, 01601
National Scientific Center - Strazhesko Institute of Cardiology
Kiev, Ukraine, 03680
Sponsors and Collaborators
Relypsa, Inc.
Medpace, Inc.
Study Director: Yuri Stasiv, Phd Relypsa, Inc.
  More Information

Additional Information:
Responsible Party: Relypsa, Inc.
ClinicalTrials.gov Identifier: NCT00868439     History of Changes
Other Study ID Numbers: RLY5016-202
Study First Received: March 23, 2009
Last Updated: November 3, 2014
Health Authority: United States: Food and Drug Administration
Czech Republic: State Institute for Drug Control
Germany: Federal Institute for Drugs and Medical Devices
Poland: Ministry of Health
Georgia: Ministry of Health
Russia: Ministry of Health of the Russian Federation
Ukraine: Ministry of Health

Keywords provided by Relypsa, Inc.:
Heart failure
chronic kidney disease
prevention of hyperkalemia in heart failure patients

Additional relevant MeSH terms:
Heart Failure
Cardiovascular Diseases
Heart Diseases
Metabolic Diseases
Water-Electrolyte Imbalance
Cardiovascular Agents
Diuretics, Potassium Sparing
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Mineralocorticoid Receptor Antagonists
Natriuretic Agents
Pharmacologic Actions
Physiological Effects of Drugs
Therapeutic Uses

ClinicalTrials.gov processed this record on December 01, 2015