Ivabradine in the Management of Cardiac Autonomic Dysfunction Associated With Thoracic Radiation Therapy.

NCT ID: NCT03137537

Last Updated: 2022-02-10

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: PHASE2
• Total Enrollment: 23 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-02-27
• Study Completion Date: 2020-11-18

Brief Summary

This study will explore whether ivabradine lowers heart rate, and thus improves exercise capacity, in survivors of lymphoma who have an elevated resting heart rate as a side effect of prior radiation treatment.

The drugs involved in this study are:

• Ivabradine
• Placebo

Detailed Description

This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational intervention to learn whether the intervention works in treating a specific disease. "Investigational" means that the intervention is being studied.

This research study is a Pilot Study, which is the first time investigators are examining this study intervention for this particular problem.

In this research study, the investigators are studying a drug called ivabradine. The investigators are exploring whether ivabradine can be used to reduce heart rate, increase exercise duration, and improve quality of life in survivors of lymphoma who received radiation to their chest as a part of their cancer treatment.

The U.S. Food and Drug Administration (FDA) has not approved ivabradine for this specific disease, but it has approved the drug as an oral medication to lower heart rate in heart failure patients.

Survivors of lymphoma who were treated with neck and/or chest radiation can have an elevated resting heart rate and an abnormal rate of decline in their heart rate after exercise, also known as cardiac autonomic dysfunction. These abnormalities can limit exercise duration and worsen quality of life in some radiation treated survivors of lymphoma

Conditions

Lymphoma; Autonomic Imbalance; Cancer Survivorship

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Ivabradine

• Ivabradine will be administered for a total of 6 weeks
• Ivabradine is taken orally twice daily
• Dosage will be adjusted according to physician determination

Group Type: EXPERIMENTAL

Ivabradine

Intervention Type: DRUG

lower heart rate in heart failure patients.

Placebo Oral Tablet

• Placebo will be administered for a total of 6 weeks
• Placebo is taken orally twice daily
• Dosage will be adjusted according to physician determination

Group Type: PLACEBO_COMPARATOR

Placebo Oral Tablet

Intervention Type: DRUG

Procedure prescribed to compare the active effect of a medicine.

Interventions

Ivabradine

lower heart rate in heart failure patients.

Intervention Type: DRUG

Placebo Oral Tablet

Procedure prescribed to compare the active effect of a medicine.

Intervention Type: DRUG

Other Intervention Names

Corlanor

Eligibility Criteria

Inclusion Criteria

• Survivors of mediastinal lymphoma (either Non-Hodgkin's Lymphoma or Hodgkin's Lymphoma) with no active malignancy
• Prior mediastinal or mantle radiation ≥ 5 years prior to enrollment in the study
• Age 18-80 years.
• Participants must have normal organ function as defined below:

• AST(SGOT)/ALT(SGPT) ≤2.5 × institutional upper limit of normal
• creatinine clearance ≥ 15 mL/min/1.73 m2 for participants with creatinine levels above institutional normal.
• Normal sinus rhythm with resting heart rate ≥ 80 bpm on screening EKG
• Based on findings in animals, ivabradine may cause fetal harm when administered to a pregnant woman. For this reason, women of child-bearing potential must agree to use adequate contraception.
• Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria

• Participants who are receiving any other investigational agents.
• History of allergic reaction to ivabradine.
• Participants receiving any medications or substances that are inhibitors or inducers of cytochrome P450 3A4 are ineligible.
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, acute coronary syndrome, symptomatic known coronary artery disease, severe valvular heart disease, active malignancy, or psychiatric illness/social situations that would limit compliance with study requirements.
• Pregnant women are excluded from this study because ivabradine is an agent with the potential for teratogenic effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with ivabradine, breastfeeding should be discontinued if the mother is treated with ivabradine.
• HIV-positive participants on combination antiretroviral therapy.
• Patients with systolic blood pressure < 90 mm Hg.
• Patients with sick-sinus syndrome, sino-atrial block, third degree heart block, atrial fibrillation, and those with permanent pacemakers.
• Patients with other established indications for ivabradine: stable, symptomatic chronic HF with a left ventricular ejection fraction ≤ 35% and in sinus rhythm with a resting HR ≥ 70 bpm, who are taking maximally tolerated doses of beta-blockers or have contraindications to beta-blocker use.
• Patients with severe hepatic dysfunction (Child Pugh Class C).
• Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Amgen

INDUSTRY

Sponsor Role: collaborator

Dana-Farber Cancer Institute

OTHER

Sponsor Role: lead

Responsible Party

Anju Nohria

Assistant Professor in Internal Medicine

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Anju Nohria, MD

Role: PRINCIPAL_INVESTIGATOR

Brigham and Women's Hospital

Locations

Massachusetts General Hospital

Boston, Massachusetts, United States

Boston Children Hospital

Boston, Massachusetts, United States

Brigham and Women's Hospital

Boston, Massachusetts, United States

Countries

United States

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

17-022

Identifier Type: -

Identifier Source: org_study_id