The Effect of an Antisense Oligonucleotide to Lower Transthyretin (TTR) Levels on the Progression of -Wild-type TTR Involving the Heart

NCT ID: NCT02627820

Last Updated: 2016-08-10

Basic Information

• Recruitment Status: WITHDRAWN
• Clinical Phase: PHASE2
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-01-31
• Study Completion Date: 2018-12-31

Brief Summary

ATTRwt (also known as senile systemic, or senile cardiac amyloidosis) is a progressive heart disease, causing congestive heart failure. It is caused by amyloid protein deposits in the heart, that are derived from a normal protein, TTR, made in the liver. The aim of the study is to determine whether lowering the blood levels of TTR, by a weekly injection of a compound designed specifically to do this, will slow the progression of the disease when treated patients are compared to previously-followed patients who were not receiving this drug. The study also aims to determine how well this drug is tolerated and the existence and severity of any drug side-effects.

Conditions

Amyloidosis

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Experimental Drug

Isis 420915/GSK 299872, an antisense oligonucleotide. Administered subcutaneously three times per week for the first week, and then weekly for 18 months. Each dose shall contain 300 mg of active drug.

Group Type: EXPERIMENTAL

Isis 420915/GSK 299872

Intervention Type: DRUG

Open label study in comparison to historic control.

Interventions

Isis 420915/GSK 299872

Open label study in comparison to historic control.

Intervention Type: DRUG

Other Intervention Names

Antisense oligonucleotide

Eligibility Criteria

Inclusion Criteria

1. Patients should, in the opinion of the Investigator, be in a stable state in terms of NYHA class. Class I-III patients will be recruited.

2. Age 50-90 years

3. Male or non-pregnant, non-lactating females. If a woman is premenopausal, or a male partners with a premenopausal woman, she/he must be willing to use the following methods of contraception: condoms, oral/hormonal contraception, Intrauterine Device, diaphragm, or abstinence

4. Written informed consent to be obtained prior to study treatment

5. Histochemical diagnosis of amyloidosis as based on detection by polarizing microscopy of green birefringent material in Congo red-stained tissue specimens

6. Molecular definition of the absence of a TTR mutation or immunohistochemical staining of amyloid fibrils with anti TTR antibody and negative genetic testing for a TTR mutation.

7. Willingness to return to the treating center for follow-up.

8. Willingness and ability to self-administer, or to have spouse administer weekly subcutaneous injections of study drug.

Exclusion Criteria

1. Patients who, in the opinion of the Investigator, require further adjustment of diuretics at the time of screening to achieve optimal treatment of heart failure. Once stable for 2 weeks, patients in Class I-III will become eligible for inclusion.

2. Patients with NYHA class 4 congestive heart failure.

3. Concomitant non-amyloid heart disease that might, in the opinion of the investigator, cause changes in strain imaging on serial follow-up (e.g. aortic stenosis of greater than mild severity, unstable coronary artery disease).

4. Prior liver transplantation or liver transplantation anticipated in less than 6 months;

5. ALT and/or AST ³ 2 x ULN and/or Alkaline phosphatase ³ 2 x UNL;

6. Estimated glomerular filtration rate (EGFR) < 50 ml/min;

7. Any other lab values that in the opinion of the investigator might place the subject at unacceptable risk for participation in the study;

8. History of poor compliance with medications or medical treatment, based on a review of medical records.

9. History of hypersensitivity to any of the ingredients of the study therapy;

10. Use of any investigational drug for amyloidosis within 4 weeks prior to study entry or during the study.

11. Current use of tafamidis, diflunisal, doxycycline or TUDCA for therapy of amyloidosis.

• Minimum Eligible Age: 50 Years
• Maximum Eligible Age: 90 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

GlaxoSmithKline

INDUSTRY

Sponsor Role: collaborator

Ionis Pharmaceuticals, Inc.

INDUSTRY

Sponsor Role: collaborator

Brigham and Women's Hospital

OTHER

Sponsor Role: lead

Responsible Party

Rodney H. Falk, MD

Director, Brigham and Women's Cardiac Amyloidosis Program

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Rodney H Falk, MD

Role: PRINCIPAL_INVESTIGATOR

Brigham and Women's Hospital

Other Identifiers

2015-P001574

Identifier Type: -

Identifier Source: org_study_id