Trimetazidine Therapy in Hypertrophic Cardiomyopathy

NCT ID: NCT01696370

Last Updated: 2013-02-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-04-30

Study Completion Date

2014-04-30

Brief Summary

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Hypertrophic cardiomyopathy (HCM) is a common inherited heart condition that causes breathlessness, chest pain and fatigue. There are few treatments available. The investigators have recently shown that a drug called perhexiline reduced symptoms and improved exercise capacity in patients with HCM. This change appears to be driven by alterations in myocardial energy metabolism. The aim of this trial is to test a similar drug, trimetazidine, in a group of symptomatic patients with non-obstructive HCM.

HYPOTHESIS: trimetazidine will improve symptoms, peak oxygen consumption, cardiac function and arrhythmia burden in medically refractory symptomatic patients with non-obstructive HCM.

Detailed Description

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BACKGROUND:

Hypertrophic cardiomyopathy (HCM) is a common inherited disorder of heart muscle affecting 1 in 500 individuals worldwide. It is associated with arrhythmias, heart failure and sudden death in young people. In the majority of patients, HCM is caused by mutations in genes encoding cardiac contractile proteins. It has been hypothesised that excessive sarcomeric energy consumption is an important and early factor in the pathophysiology of HCM. Therefore modulation of myocardial metabolism presents a novel target for improving myocardial performance and symptoms in patients with HCM. Trimetazidine is an anti-anginal agent which like perhexiline reduces fatty acid oxidation and increases glucose oxidation, thus increasing the efficiency of energy production. Trimetazidine has been shown to significantly improve exercise performance in patients with stable angina, ischaemic and non ischaemic cardiomyopathy, either as monotherapy or in combination with beta-blockers or calcium channel blockers,

DESIGN: A single centre prospective randomised, double blind, placebo-controlled, trial of trimetazidine therapy.

DOSING: 20 mg Trimetazidine or Placebo three times daily for three months

METHODS: The following assessments will be made at baseline and after 3 months treatment: history and physical examination, Minnesota heart failure questionnaire, fasting blood tests, electrocardiogram, echocardiogram, cardiopulmonary exercise test, six minute walk test, 24 hour ECG Holter monitor.

Conditions

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Hypertrophic Cardiomyopathy

Keywords

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Trimetazidine

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Trimetazidine

Group Type ACTIVE_COMPARATOR

Trimetazidine

Intervention Type DRUG

Trimetazidine 20mg three times per day for 3 months

Placebo capsule

Group Type PLACEBO_COMPARATOR

Placebo capsule

Intervention Type OTHER

one capsule three times per day for 3 months

Interventions

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Trimetazidine

Trimetazidine 20mg three times per day for 3 months

Intervention Type DRUG

Placebo capsule

one capsule three times per day for 3 months

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Non-obstructive hypertrophic cardiomyopathy (gradient \<30 mmHg at rest)
* NYHA (New York Heart Association) Class ≥ 2
* Peak VO2 (maximal oxygen consumption) ≤80% predicted for age and gender
* Heart rate \< 90/minute at rest

Exclusion Criteria

* Diabetes Mellitus
* Abnormal renal function (GFR\<60ml/min) or hepatic impairment
* Female who is pregnant, lactating or planning pregnancy during the course of the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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British Heart Foundation

OTHER

Sponsor Role collaborator

University College, London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Perry M Elliott, MBBS MD

Role: PRINCIPAL_INVESTIGATOR

University College, London

Locations

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The Heart Hospital, UCLH

London, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Perry M Elliott, MBBS MD

Role: CONTACT

Phone: 020 3456 7898

Email: [email protected]

Caroline J Coats, MBBS

Role: CONTACT

Phone: 020 3456 7898

Email: [email protected]

References

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Coats CJ, Pavlou M, Watkinson OT, Protonotarios A, Moss L, Hyland R, Rantell K, Pantazis AA, Tome M, McKenna WJ, Frenneaux MP, Omar R, Elliott PM. Effect of Trimetazidine Dihydrochloride Therapy on Exercise Capacity in Patients With Nonobstructive Hypertrophic Cardiomyopathy: A Randomized Clinical Trial. JAMA Cardiol. 2019 Mar 1;4(3):230-235. doi: 10.1001/jamacardio.2018.4847.

Reference Type DERIVED
PMID: 30725091 (View on PubMed)

Other Identifiers

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10/0216

Identifier Type: -

Identifier Source: org_study_id