Immunosuppressive Treatment in Chronic Virus-Negative Inflammatory Cardiomyopathy

NCT ID: NCT05570409

Last Updated: 2025-07-25

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

TERMINATED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

9 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-28

Study Completion Date

2025-04-14

Brief Summary

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Evaluating Immunosuppressive treatment (Mycophenolate mofetil and prednisolon compared to placebo) for 6 months in patients with chronic virus- Negative Inflammatory cardiomyopathy - a multicenter, randomized, double-blind, placebo-controlled trial.

Detailed Description

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Inflammatory cardiomyopathy constitutes a relevant part of the cohort of non-dilated left ventricular cardiomyopathy / dilated cardiomyopathy (DCM) and is associated with adverse outcome. Urgent medical needs remain with respect to the therapeutic options for inflammatory cardiomyopathy. So far, no specific therapy for patients with inflammatory cardiomyopathy is available. Existing data on immunosuppression for inflammatory cardiomyopathy is preliminary and needs further validation by larger randomized, controlled, multicenter trials.

Patients with biopsy-proven virus-negative inflammatory dilated or non-dilated left ventricular cardiomyopathy and moderate to severe deterioration of cardiac function despite optimal medical treatment (OMT) for heart failure (HF) will be randomized (1:1) in a double-blinded way to Mycophenolate mofetil (MMF) 1g bid and prednisolone at initially 1mg/kg in a step-down regime for 6 months or placebo. The clinical benefit will be measured with respect to absolute increase in LVEF (metric and binary co-primary endpoints assessed by MRI core lab) of immunosuppressive treatment with MMF and prednisolone compared to placebo at 12 months follow-up.

Conditions

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Inflammatory Cardiomyopathy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Investigator-initiated, multicenter, randomized, double-blind, placebocontrolled clinical trial
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Immunosuppressive treatment

Mycophenolate mofetil (MMF) 1g bid and prednisolone at initially 1mg/kg in a step-down regime

Group Type EXPERIMENTAL

Mycophenolate Mofetil

Intervention Type DRUG

Mycophenolate mofetil 1g bid for 6 months

Prednisolone

Intervention Type DRUG

initially 1mg/kg in a step-down regime for 6 months

Placebo

Mycophenolate mofetil (MMF) and prednisolone Placebo

Group Type PLACEBO_COMPARATOR

Mycophenolate Mofetil Placebo

Intervention Type DRUG

MMF matching Placebo

Prednisolone Placebo

Intervention Type DRUG

Prednisolone matching placebo

Interventions

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Mycophenolate Mofetil

Mycophenolate mofetil 1g bid for 6 months

Intervention Type DRUG

Prednisolone

initially 1mg/kg in a step-down regime for 6 months

Intervention Type DRUG

Mycophenolate Mofetil Placebo

MMF matching Placebo

Intervention Type DRUG

Prednisolone Placebo

Prednisolone matching placebo

Intervention Type DRUG

Other Intervention Names

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MMF MMF Placebo

Eligibility Criteria

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Inclusion Criteria

1. Age ≥18 years
2. Medical therapy for HF for ≥3 months and \<10 years according to current guideline recommendations
3. Persistent reduction of LVEF \<50% on a routine echocardiographic evaluation (Simpson's biplane) not older than 1 month at time of inclusion
4. EMB with immunohistochemical evidence of lymphocytic myocarditis defined as ≥14 leukocytes/mm2 including up to 4 monocytes/mm2 with the presence of CD3 positive T-lymphocytes ≥7 cells/mm2 and increased MHC-II expression as approved by the histopathology core lab
5. Absence of established cardiotropic virus infection in EMBs (i.e. enteroviruses, HHV-6, EBV, CMV, adenoviruses, parvovirus B19 \>500 copies) as approved by the histopathology core lab
6. Negative pregnancy test and the use of a highly effective contraceptive measure in women with child-bearing potential (according to CTFG recommendations)
7. Written informed consent.

Exclusion Criteria

1. Histopathological (as approved by the histopathology core lab) and/ or clinical evidence of acute lymphocytic myocarditis, sarcoidosis, GCM or eosinophilic myocarditis,
2. Known systemic inflammatory disease,
3. Recent major surgery within \<6 weeks, recent ICD implantation within \<6 weeks or recent CRT implantation within \<3 months prior to,
4. Known coronary artery disease responsible for cardiac dysfunction (i.e., prior myocardial infarction, persistent stenosis ≥ 70%),
5. Pregnancy or lactation,
6. Contraindications to immunosuppressive treatment with MMF + corticosteroids,
7. Inability to provide informed consent.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK)

OTHER

Sponsor Role collaborator

Technical University of Munich

OTHER

Sponsor Role collaborator

Charite University, Berlin, Germany

OTHER

Sponsor Role collaborator

University Hospital, Essen

OTHER

Sponsor Role collaborator

University Hospital Erlangen

OTHER

Sponsor Role collaborator

University Hospital Tuebingen

OTHER

Sponsor Role collaborator

LMU Klinikum

OTHER

Sponsor Role lead

Responsible Party

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Steffen Massberg

Prof. Dr. med.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Steffen Massberg, Prof Dr. med.

Role: PRINCIPAL_INVESTIGATOR

LMU Klinikum

Locations

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Kerckhoff-Klinik GmbH

Bad Nauheim, , Germany

Site Status

Charité - University Hospital Berlin

Berlin, , Germany

Site Status

University Hospital Essen

Essen, , Germany

Site Status

UHF- Universitäres Herz- und Gefässzentrum

Frankfurt, , Germany

Site Status

University Hospital Freiburg - Bad Krozingen

Freiburg im Breisgau, , Germany

Site Status

Universitätsmedizin Göttingen

Göttingen, , Germany

Site Status

University Hospital Greifswald

Greifswald, , Germany

Site Status

UKE Hamburg

Hamburg, , Germany

Site Status

University Hospital Heidelberg

Heidelberg, , Germany

Site Status

Universitäres Herzzentrum Lübeck

Lübeck, , Germany

Site Status

Klinikum rechts der Isar

Munich, , Germany

Site Status

LMU Klinikum

Munich, , Germany

Site Status

LMU Klinikum Standort Innenstadt

München, , Germany

Site Status

University Hospital Regensburg

Regensburg, , Germany

Site Status

Countries

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Germany

Related Links

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Other Identifiers

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TRINITY

Identifier Type: -

Identifier Source: org_study_id

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