Researchers are looking for a better way to treat children who have heart failure with left ventricular systolic dysfunction (LVSD). Heart failure is a serious condition where the heart is unable to pump enough blood to meet the body's needs. This can lead to symptoms like shortness of breath, fatigue, and poor growth in children. The study treatment, finerenone (also called BAY94-8862), works by blocking a protein involved in inflammation, scarring, and thickening of the heart and blood vessels. This may help the heart to pump blood more effectively. This is the first study to explore its use specifically for children with heart failure and LVSD. The main purpose of this study is to learn if finerenone works to help the heart compared to placebo in children with heart failure and LVSD. For this, the researchers will collect and analyze data on the levels of a protein called NT-proBNP in the blood, which indicates heart stress, and monitor the safety of the treatment. The study will include children with heart failure and LVSD aged from 6 months to less than 18 years. The study participants will be randomly assigned to one of two treatment groups. Based on their group, they will receive either finerenone or a placebo for a duration of 3 months. A placebo looks like a treatment but does not have any medicine in it. Throughout the study, all participants will continue to receive their standard heart failure treatments. At the start of this study, the doctors will check each participant's medical history and current medications. If participants qualify for the treatment phase, they will undergo treatment for about 90 days. During this time, they will visit the study site at least 3 times. During these visits, the participants will: * have their blood pressure, heart rate, temperature, respiratory rate, height and weight measured * have their heart examined by electrocardiogram (ECG) and echocardiogram * have blood samples taken * have physical examinations * answer questions about their medication and whether they have any adverse events, or have their parents or guardians' answers An adverse event is any medical problem that a participant has during a study. Doctors keep track of all adverse events that happen in studies, even if they do not think the adverse events might be related to the study treatments. After the initial three-month study, eligible participants will have the option to join a nine-month open-label extension study where all will receive finerenone. Participants who choose not to enroll in the extension will have a follow-up visit 30 days after their last treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
111
Finerenone in different doses, treatment duration will be 90±3 days
Placebo to finerenone, treatment duration will be 90±3 days
Children's Hospital Colorado - Anschutz Medical Campus - Cardiology
Aurora, Colorado, United States
NOT_YET_RECRUITINGNemours Children's Hospital - Delaware - Cardiology
Wilmington, Delaware, United States
NOT_YET_RECRUITINGUF Health Shands Hospital - Pediatric Cardiology
Gainesville, Florida, United States
NOT_YET_RECRUITINGJoe Dimaggio Children's Hospital - Cardiology
Hollywood, Florida, United States
Change in NT-proBNP levels
Time frame: From baseline to Day 90±3
Number of participants with treatment-emergent adverse events (TEAEs)
TEAEs will be mapped to Medical Dictionary for Regulatory Activities (MedDRA) terms
Time frame: From the start of study intervention to last study intervention (up to 93 days) + 3 days
Change in serum potassium levels
Time frame: From baseline to Day 90±3
Change in estimated glomerular filtration rate (eGFR)
Time frame: From baseline to Day 90±3
Change in systolic blood pressure (SBP)
Time frame: From baseline to Day 90±3
Change in left ventricular systolic function
Change measured by echocardiogram (%) from baseline to Day 90±3
Time frame: From baseline to Day 90±3
Total number of cardiovascular outcome events, including cardiovascular death, heart transplantation, and clinical worsening of heart failure
Time frame: From baseline to Day 90±3
Maximum observed finerenone concentration in plasma after multiple doses (Cmax, md)
Time frame: Pre-dose, post-dose (1.5-5 hours after intake of intervention), up to day 90±3
Area under the curve for finerenone concentration in plasma after multiple doses (AUCτ,md)
Time frame: Pre-dose, post-dose (1.5-5 hours after intake of intervention), up to day 90±3
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Emory University Hospital - Children's Healthcare of Atlanta Cardiology - Atlanta
Atlanta, Georgia, United States
NOT_YET_RECRUITINGRiley Hospital For Children - Cardiology
Indianapolis, Indiana, United States
NOT_YET_RECRUITINGBoston Children's Hospital - Main Campus - Cardiology
Boston, Massachusetts, United States
NOT_YET_RECRUITINGC.S. Mott Children's Hospital - Cardiology
Ann Arbor, Michigan, United States
NOT_YET_RECRUITINGChildren's Mercy Hospital Kansas City - Cardiology
Kansas City, Missouri, United States
NOT_YET_RECRUITINGWashington University - St. Louis Children's Hospital - Cardiology
St Louis, Missouri, United States
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