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Phase 3 N=17 Randomized Double-blind Treatment

Study to Evaluate Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of LCZ696 Followed by a 52-week, Double-blind Study of LCZ696 Compared With Enalapril in Pediatric Patients With Heart Failure

Pediatric Heart Failure

Enrolled (actual)
17
Serious AEs
32.5%
Results posted
Feb 2023
Primary outcome: Primary: Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Maximum Drug Concentration in Plasma (Cmax) — 523; 179; 1970; 549 nanograms per milliliter (ng/ml)

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
LCZ696 (Drug); Enalapril (Drug); Placebo of LCZ696 (Drug); Placebo of Enalapril (Drug)
Age
Pediatric · 0+ yrs
Sex
All
Sponsor
Novartis Pharmaceuticals
Primary completion
Jan 2022

Outcome Measures

OutcomeResultp-value
PRIMARY
Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Maximum Drug Concentration in Plasma (Cmax)
523; 179; 1970; 549; 124; 433
PRIMARY
Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Time to Maximum Plasma Concentration (Tmax)
1.1; 1.2; 0.8; 1.2; 1.1; 1.0
PRIMARY
Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUCinf)
690; 494; 3021; 1214; 270; 1063
PRIMARY
Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Number of Participants With Area Under the Plasma Concentration-time Curve From Time Zero to Last (AUClast)
7; 8; 7; 6; 4; 5
PRIMARY
Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril, and Valsartan): Clearance From Plasma (CL/F)
0.73; 1.19; 0.63; 1.67; 1.19; 1.67
PRIMARY
Part 1: Pharmacokinetics of LCZ696 Analytes (Sacubitril): Time Required to Drug Concentration to Decrease by Half (T 1/2)
1.26; 1.53; 1.34; 1.51; 1.33
PRIMARY
Part 1: Pharmacodynamics (PD) of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Change From Baseline in Plasma B-type Natriuretic Peptide (BNP)
100.87; 63.80; 97.52; 120.51; 21.20; 129.29
PRIMARY
Part 1: Pharmacodynamics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Change From Baseline in Plasma N-terminal Pro-brain Natriuretic Peptide (NTproBNP)
2385.34; 2179.94; 961.76; 5086.37; 0.74; 0.59
PRIMARY
Part 1: Pharmacodynamics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Change From Baseline in Plasma Cyclic Guanosine Monophosphate (cGMP)
18.18; 21.41; 12.20; 24.55; 13.38; 22.84
PRIMARY
Part 1: Pharmacodynamics of LCZ696 Analytes (Sacubitril, LBQ657, and Valsartan): Change From Baseline in Urine cGMP
1055.56; 1349.91; 914.57; 1123.69; 485.00; 386.32
PRIMARY
Part 2: Percentage of Participants With Worst Event in Each Category Based on Global Ranking
10.16; 15.96; 9.63; 4.79; 6.95; 5.85
SECONDARY
Part 1: Percentage of Participants With Treatment Emergent Adverse Events (TEAEs)
28.57; 50.00; 28.57; 50.00; 50.00; 80.00
SECONDARY
Part 2: Percentage of Participants With Treatment Emergent Adverse Events (TEAEs)
88.77; 87.77
SECONDARY
Part 2: Exposure-adjusted Incidence Rate of Category 1 or Category 2 Event
20.133; 20.042 0.7958
SECONDARY
Part 2: Percentage of Participants With Change From Baseline in New York Heart Association (NYHA)/Ross Functional Class
14.21; 15.67; 84.15; 82.61; 1.64; 1.63
SECONDARY
Part 2: Percentage of Participants With Change From Baseline in Patient Global Impression of Severity (PGIS) Score
27.01; 29.67; 58.05; 59.89; 14.94; 10.44
SECONDARY
Part 1 and Part 2: Population PK of LCZ696 Analytes: Clearance From Plasma (CL)
25.93; 0.44; 1.97
SECONDARY
Part 1 and Part 2: Population PK of LCZ696 Analytes: Volume of Distribution in Steady State
4.67; 0.34; 0.68
SECONDARY
Part 1 and Part 2: Population PK of LCZ696 Analytes: Absorption Rate Constant (Ka)
1.25; 1.04; 1.42
SECONDARY
Part 1 and Part 2: Population PK of LCZ696 Analytes: Time Required to Drug Concentration to Decrease by Half (T 1/2)
8.51; 18.21; 7.96
SECONDARY
Part 1 and Part 2: Population PK of LCZ696 Analytes: Maximum Drug Concentration in Plasma at Steady State (Cmax,ss)
1348; 10153; 3861
SECONDARY
Part 1 and Part 2: Population PK of LCZ696 Analytes: Lowest Plasma Concentration Observed During a Dosing Interval at Steady State (Cmin,ss)
63; 6442; 1442
SECONDARY
Part 1 and Part 2: Population PK of LCZ696 Analytes: Area Under the Plasma Concentration-time Curve From Time Zero to the End of the Dosing Interval Tau at Steady State (AUCtau,ss)
2179; 98906; 28672

Summary

This study consists of two parts (Part 1 and Part 2). The purpose of Part 1 is to evaluate the way the body absorbs, distributes, metabolizes and removes the drug LCZ696. This will help determine the proper dose of LCZ696 for Part 2 of the study. The purpose for Part 2 is to compare the effectiveness and safety of LCZ696 with enalapril in a double-blind manner, in pediatric heart failure patients over 52 weeks of treatment.

Eligibility Criteria

Key Inclusion Criteria

  • Chronic heart failure (CHF) resulting from left ventricular systolic dysfunction, and receiving chronic HF therapy (if not newly diagnosed)
  • New York Heart Association (NYHA) classification II-IV (older children: 6 to 5.3 mmol/L
  • History of angioedema
  • Allergy or hypersensitivity to ACEI / ARB
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02678312). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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