A Study of Vericiguat in Participants With Heart Failure With Reduced Ejection Fraction (HFrEF) (MK-1242-001)

Merck Sharp & Dohme LLC5,050 enrolled

Overview

This is a randomized, placebo-controlled, parallel-group, multi-center, double-blind, event driven study of vericiguat (MK-1242) in participants with heart failure with reduced ejection fraction (HFrEF). The primary hypothesis is vericiguat (MK-1242) is superior to placebo in increasing the time to first occurrence of the composite of cardiovascular (CV) death or heart failure (HF) hospitalization in participants with HFrEF.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

5,050

Conditions

Heart Failure Chronic Heart Failure With Reduced Ejection Fraction

Interventions

VericiguatDRUG

2.5, 5.0, or 10.0 mg orally once daily

Placebo for vericiguatDRUG

2.5, 5.0, or 10.0 mg orally once daily

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * History of chronic HF (New York Heart Association \[NYHA\] Class II-IV) on standard therapy before qualifying HF decompensation * Previous HF hospitalization within 6 months prior to randomization or intravenous (IV) diuretic treatment for HF (without hospitalization) within 3 months. * Brain natriuretic peptide (BNP) levels: sinus rhythm-≥ 300 pg/mL; atrial fibrillation-≥ 500 pg/mL and N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) levels: sinus rhythm- ≥ 1000 pg/mL; atrial fibrillation - ≥ 1600 pg/mL within 30 days prior to randomization * Left ventricular ejection fraction (LVEF) of \<45% assessed within 12 months prior to randomization by any method * If female, is not of reproductive potential or agrees to avoid becoming pregnant while receiving study drug and for 14 days after the last dose of study drug by complying with one of the following: practice abstinence from heterosexual activity or use (or have her partner use) acceptable contraception during heterosexual activity. Exclusion Criteria: * Clinically unstable at the time of randomization as defined by either the administration of any IV treatment within 24 hours prior to randomization, and/or systolic blood pressure (SBP) \<100 mmHg or symptomatic hypotension * Current or anticipated use of long-acting nitrates or nitric oxide (NO) donors including isosorbide dinitrate, isosorbide 5-mononitrate, pentaerythritol tetranitrate, nicorandil or transdermal nitroglycerin (NTG) patch, and molsidomine * Current or anticipated use of phosphodiesterase type 5 (PDE5) inhibitors such as vardenafil, tadalafil, and sildenafil * Current use or anticipated use of a soluble guanylate cyclase (sGC) stimulator such as riociguat * Known allergy or sensitivity to any sGC stimulator * Awaiting heart transplantation (United Network for Organ Sharing Class 1A / 1B or equivalent), receiving continuous IV infusion of an inotrope, or has/anticipates receiving an implanted ventricular assist device * Primary valvular heart disease requiring surgery or intervention, or is within 3 months after valvular surgery or intervention * Hypertrophic obstructive cardiomyopathy * Acute myocarditis, amyloidosis, sarcoidosis, Takotsubo cardiomyopathy * Post-heart transplant cardiomyopathy * Tachycardia-induced cardiomyopathy and/or uncontrolled tachyarrhythmia * Acute coronary syndrome (unstable angina, non-ST elevation myocardial infarction \[NSTEMI\], or ST elevation myocardial infarction \[(STEMI\]) or coronary revascularization (coronary artery bypass grafting \[CABG\] or percutaneous coronary intervention \[PCI\]) within 60 days, or indication for coronary revascularization at time of randomization * Symptomatic carotid stenosis, transient ischemic attack (TIA) or stroke within 60 days * Complex congenital heart disease * Active endocarditis or constrictive pericarditis * Estimated glomerular filtration rate (eGFR) \<15 mL/min/1.73 m2 or chronic dialysis * Severe hepatic insufficiency such as with hepatic encephalopathy * Malignancy or other non-cardiac condition limiting life expectancy to \<3 years * Require continuous home oxygen for severe pulmonary disease * Current alcohol and/or drug abuse * Participated in another interventional clinical study and treatment with another investigational product ≤30 days prior to randomization or plans to participate in any other trial/investigation during the duration of this study * Mental or legal incapacitation and is unable to provide informed consent * Immediate family member (e.g., spouse, parent/legal guardian, sibling or child) who is involved with this study * Interstitial Lung Disease * Is pregnant or breastfeeding or plans to become pregnant or to breastfeed during the course of the study

Outcomes

Primary Outcomes

Time to First Occurrence of Composite Endpoint of Cardiovascular (CV) Death or Heart Failure (HF) Hospitalization

Time to First Occurrence of Composite Endpoint of CV Death or HF Hospitalization was analyzed using a one-sided stratified log-rank test. Randomized participants without any HF hospitalization or CV death event at the time of analysis were censored at their last available information, the date of their non-CV death, or the primary analysis database cutoff date of 18-June-2019, whichever occurred first. A clinical events committee (CEC) reviewed and adjudicated the endpoint events. A time-to-event methodology was used to evaluate the results; the incidence rate of participants with an event (number of participants with an event per 100 participant-years at risk) is provided.

Time frame: Up to approximately 33 months (through primary analysis database cutoff date of 18-June-2019)

Secondary Outcomes

Time to the First Occurrence of CV Death

Time to First Occurrence of CV Death was analyzed using a one-sided stratified log-rank test. Randomized participants without a CV death at the time of analysis were censored at their last available information, the date of their non-CV death, or the primary analysis database cutoff date of 18-June-2019, whichever occurred first. A CEC reviewed and adjudicated the endpoint events. A time-to-event methodology was used to evaluate the results; the incidence rate of participants with an event (number of participants with an event per 100 participant-years at risk) is provided.

Time frame: Up to approximately 33 months (through primary analysis database cutoff date of 18-June-2019)

Time to the First Occurrence of HF Hospitalization

Time to the First Occurrence of HF Hospitalization was analyzed using a one-sided stratified log-rank test. Randomized participants without any HF hospitalization at the time of analysis were censored at their last available information, the date of their death, or the primary analysis database cutoff date of 18-June-2019, whichever occurred first. A CEC reviewed and adjudicated the endpoint events. A time-to-event methodology was used to evaluate the results; the incidence rate of participants with an event (number of participants with an event per 100 participant-years at risk) is provided.

Data from ClinicalTrials.gov

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