A Phase 2 interventional study of Serelaxin and Placebo in Coronary Artery Disease, sponsored by Novartis Pharmaceuticals. Completed at 3 sites in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-07-01.
Sponsored by Novartis Pharmaceuticals · Phase 2, Interventional, and Treatment
This was a mechanistic study in patients with coronary artery disease on the effects of Serelaxin on micro- and macrovascular function.
double blind, randomized, parallel group, placebo controlled study
5,598 studies on the registry are indexed under Coronary Artery Disease; 957 are open to participants now.
This study's enrollment of 58 is below the median of 124 across 3,436 interventional studies indexed under Coronary Artery Disease.
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Serelaxin was administered at a dose of 30 μg/kg/24h by intravenous infusion for 48 hours
Drug: Serelaxin
Placebo was administered by intravenous infusion for 48 hours
Other: Placebo
Serelaxin solution diluted in 5% glucose volume/volume (v/v) solution
Also known as: RLX030, relaxin
5% v/v glucose solution
Statistical Analysis of Change From Baseline to Day 3 in Myocardial Perfusion Endpoints Compared With Mid Perfusion Reserve Index Using ANCOVA End Points
Global MPRI (Myocardial Perfusion Reserve Index) is defined as ratio between mean global myocardial blood flow values at rest and during adenosine stress with Mid Perfusion Reserve Index or Midl PRI (Mid Perfusion Reserve Index) which is defined as ratio between mid myocardial blood flow values at rest and during adenosine stress
Time frame: baseline to Day 3
Change From Baseline in Aortic Distensibility Measured by MRI
Measurements of arterial stiffness from cardiac MRI - Mean (SD) \[n\] Aortic distensibility was assessed by MRI and pulse wave velocity using the SphygmoCor device. (mmHg-1)
Time frame: At pre-dose on Day 1 (baseline) until Day 180 after the start of drug infusion
Change From Baseline in Aortic Velocity
Summary table for measurements of arterial velocity from cardiac MRI - Mean (SD) \[n\] Aortic distensibility was assessed by MRI and pulse wave velocity using the SphygmoCor device
Time frame: At pre-dose on Day 1 (baseline) until Day 180 after the start of drug infusion
Change From Baseline in Augmentation Index Measured From Sphygmocor Device
Summary of values and change from baseline in augmentation index by time and treatment The change from baseline in Augmentation Index was analyzed using a repeated measures analysis of covariance including treatment, time, treatment by time, baseline by time interactions and baseline as fixed factors with an unstructured variance-covariance matrixStatistical analysis of change from baseline in augmentation index using repeated measures Analysis of Covariance
Time frame: Day1, Day 2, Day 3, Day 30 and Day 180 after the start of infusion
Statistical Analysis of Change From Baseline in Augmentation Index Using Repeated Measures Analysis of Covariance
The change from baseline in Augmentation Index was analyzed using a repeated measures analysis of covariance including treatment, time, treatment by time, baseline by time interactions and baseline as fixed factors with an unstructured variance-covariance matrixStatistical analysis of change from baseline in augmentation index using repeated measures Analysis of Covariance For analysis of change from baseline, only subjects with results at both baseline and post-baseline could be included The augmentation index is a ratio calculated from the blood pressure waveform, it is a measure of wave reflection and arterial stiffness. Augmentation index is commonly accepted as a measure of the enhancement (augmentation) of central aortic pressure by a reflected pulse wave
Time frame: Day1, Day 2, Day 3, Day 30 and Day 180 after the start of infusion
Change From Baseline in Pulse Wave Velocity Measured From Carotid-femoral Pulse Wave Analysis
Pulse wave velocity was assessed by the SphygmoCor device
Time frame: Day1, Day 2, Day 3, Day 30 and Day 180 after the start of infusion
Serum Concentration of Serelaxin
Summary statistics of serelaxin serum PK concentrations Blood samples were taken to measure serelaxin concentration
Time frame: Day1, Day 2, Day 3 and Day 30 after the start of infusion
Serum Concentration of Antibodies to Serelaxin
Frequency and percentage of anti-Serelaxin antibodies Blood samples were taken to measure antibodies to serelaxin concentration at Pre-dose on Day 1, and at Day 30 after the start of the 48h drug infusion
Time frame: From pre-dose on Day 1 until Day 30 after the start of drug infusion
Systemic Clearance of Serelaxin
Systemic clearance was estimated using the rate of serelaxin infusion and the steady state concentration
Time frame: From pre-dose on Day 1 until 48h after the start of drug infusion
Out of the total 63 participants screened, 62 were randomized. 4 of the randomized participants did not receive study drug, and 58 did receive study drug
| Milestone | Serelaxin | Placebo |
|---|---|---|
| Started | 30 | 28 |
| Safety analysis set | 30 | 28 |
| Pk analysis set | 30 | 0 |
| Pd analysis set | 25 | 26 |
| Completed | 29 | 27 |
| Not completed | 1 | 1 |
| Withdrew: Adverse event | 1 | 1 |
Global MPRI (Myocardial Perfusion Reserve Index) is defined as ratio between mean global myocardial blood flow values at rest and during adenosine stress with Mid Perfusion Reserve Index or Midl PRI (Mid Perfusion Reserve Index) which is defined as ratio between mid myocardial blood flow values at rest and during adenosine stress
| ratio | Serelaxin | Placebo |
|---|---|---|
| Global Myocardial Perfusion Reserve Index (MPRI) | -0.244 (-0.454 to -0.035) | -0.133 (-0.329 to -0.064) |
| Mid Perfusion Reserve Index | -0.264 (-0.519 to -0.010) | -0.075 (-0.313 to 0.164) |
Measurements of arterial stiffness from cardiac MRI - Mean (SD) \[n\] Aortic distensibility was assessed by MRI and pulse wave velocity using the SphygmoCor device. (mmHg-1)
| mmHg-1 | Serelaxin | Placebo |
|---|---|---|
| Ascending Aorta Distensibility, Day 0 | 0.0017 ± 0.00158 | 0.0014 ± 0.00192 |
| Ascending Aorta Distensibility, Day 47 | 0.0015 ± 0.00124 | 0.0015 ± 0.00134 |
| Descending Aorta Distensibility, Day 0 | 0.0023 ± 0.00146 | 0.0019 ± 0.00221 |
| Descending Aorta Distensibility, Day 47 | 0.0023 ± 0.00118 | 0.0023 ± 0.00142 |
Summary table for measurements of arterial velocity from cardiac MRI - Mean (SD) \[n\] Aortic distensibility was assessed by MRI and pulse wave velocity using the SphygmoCor device
| cm/s | Serelaxin | Placebo |
|---|---|---|
| Peak Flow Velocity (cm/s), Day 0 (n=24, 24) | 127.981 ± 60.7571 | 106.557 ± 38.9573 |
| Peak Flow Velocity (cm/s), Day 47 (n=23, 25) | 127.981 ± 60.7571 | 106.557 ± 38.9573 |
Summary of values and change from baseline in augmentation index by time and treatment The change from baseline in Augmentation Index was analyzed using a repeated measures analysis of covariance including treatment, time, treatment by time, baseline by time interactions and baseline as fixed factors with an unstructured variance-covariance matrixStatistical analysis of change from baseline in augmentation index using repeated measures Analysis of Covariance
| ratio | Serelaxin | Placebo |
|---|---|---|
| DAY 1, 2h (n=23,25) | -4.12 ± 11.441 | -2.48 ± 11.560 |
| DAY 1, 6h (n=24,26) | -2.99 ± 9.066 | -0.58 ± 9.551 |
| DAY 2, 24h (n=24,25) | -0.82 ± 8.173 | 0.22 ± 9.906 |
| DAY 3, 47h (n=23,25) | 3.51 ± 10.608 | 0.22 ± 12.057 |
| DAY 3, 50h (n=22, 24) | -0.67 ± 13.034 | -3.81 ± 9.397 |
| DAY 3, 54h (n=22,25) | -1.37 ± 12.253 | -0.48 ± 11.748 |
| DAY 30 (n=25, 26) | -0.83 ± 11.462 | 0.58 ± 12.124 |
| DAY 180 (n=24,25) end of study | 0.24 ± 6.885 | 0.54 ± 11.795 |
The change from baseline in Augmentation Index was analyzed using a repeated measures analysis of covariance including treatment, time, treatment by time, baseline by time interactions and baseline as fixed factors with an unstructured variance-covariance matrixStatistical analysis of change from baseline in augmentation index using repeated measures Analysis of Covariance For analysis of change from baseline, only subjects with results at both baseline and post-baseline could be included The augmentation index is a ratio calculated from the blood pressure waveform, it is a measure of wave reflection and arterial stiffness. Augmentation index is commonly accepted as a measure of the enhancement (augmentation) of central aortic pressure by a reflected pulse wave
| ratio | Serelaxin | Placebo |
|---|---|---|
| DAY 1, 2h (n=23,25) | -4.088 (-7.967 to -0.210) | -1.970 (-5.693 to 1.753) |
| DAY 1, 6h (n=24,26) | -3.277 (-6.129 to -0.425) | -0.394 (-3.139 to 2.352) |
| DAY 2, 24h (n=24,25) | -0.774 (-4.016 to 2.469) | 0.070 (-3.108 to 3.247) |
| DAY 3, 47h (n=23,25) | 3.488 (-0.470 to 7.445) | 0.035 (-3.778 to 3.849) |
| DAY 3, 50h (n=22, 24) | -0.764 (-5.208 to 3.680) | -4.015 (-8.273 to 0.243) |
| DAY 3, 54h (n=22,25) | -1.737 (-5.915 to 2.440) | -0.753 (-4.689 to 3.182) |
| DAY 30 (n=25, 26) | -0.979 (-4.912 to 2.954) | 0.776 (-3.081 to 4.633) |
| DAY 180 (n=24,25) end of study | 0.234 (-3.066 to 3.535) | 0.284 (-2.950 to 3.518) |
Pulse wave velocity was assessed by the SphygmoCor device
| meters/second | Serelaxin | Placebo |
|---|---|---|
| DAY 1, 0hrs (n=25,26) | 7.453 ± 2.0541 | 8.166 ± 1.9515 |
| DAY 2, 24hrs (n=19,24) | 7.051 ± 1.8790 | 7.677 ± 2.1361 |
| DAY 3, 47hrs (n=22,23) | 7.195 ± 1.9164 | 8.264 ± 2.4964 |
| DAY 30, 0hrs (n=23, 24) | 7.989 ± 1.8151 | 8.463 ± 2.4437 |
| DAY 3, 47hrs (n=23,25) | 29.57 ± 9.751 | 26.04 ± 10.039 |
| DAY 180 EOS (n=23,24) | 8.335 ± 2.1087 | 8.844 ± 2.1739 |
Summary statistics of serelaxin serum PK concentrations Blood samples were taken to measure serelaxin concentration
| pg/mL | Serelaxin |
|---|---|
| DAY 1, 0hrs (n=30) | 0.637 ± 3.49 |
| DAY 2, 24hrs, (n=26) | 27600 ± 79000 |
| DAY 3, 48hrs (n=22) | 26300 ± 48000 |
| DAY 3, 50 hrs (n=21) | 7940 ± 8450 |
| DAY 3, 54hrs, (n=22) | 3960 ± 3140 |
| DAY 30 (n=30) | 0.00 ± 0.00 |
Frequency and percentage of anti-Serelaxin antibodies Blood samples were taken to measure antibodies to serelaxin concentration at Pre-dose on Day 1, and at Day 30 after the start of the 48h drug infusion
| percentage of participants | Serelaxin | Placebo |
|---|---|---|
| DAY 1 NEGATIVE | 100 | 100 |
| DAY 1 POSITIVE | 0 | 0 |
| DAY 30 NEGATIVE | 100 | 100 |
| DAY 30 POSITIVE | 0 | 0 |
Systemic clearance was estimated using the rate of serelaxin infusion and the steady state concentration
| mL/hr/kg | Serelaxin |
|---|---|
| Systemic Clearance of Serelaxin | 107 ± 80.6 |
Collected over Day 180. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Serelaxin | — | 5/30 (16.7%) | 16/30 (53.3%) |
| Placebo | — | 7/28 (25%) | 18/28 (64.3%) |
| Event | Serelaxin | Placebo |
|---|---|---|
| Acute myocardial infarctionCardiac disorders | 2/30 | 1/28 |
| Angina pectorisCardiac disorders | 1/30 | 1/28 |
| Angina unstableCardiac disorders | 1/30 | 1/28 |
| Type IV hypersensitivity reactionImmune system disorders | 0/30 | 1/28 |
| PneumoniaInfections and infestations | 0/30 | 1/28 |
| Cardiac procedure complicationInjury, poisoning and procedural complications | 0/30 | 1/28 |
| Vascular procedure complicationInjury, poisoning and procedural complications | 0/30 | 1/28 |
| PresyncopeNervous system disorders | 0/30 | 1/28 |
| HypoxiaRespiratory, thoracic and mediastinal disorders | 0/30 | 1/28 |
| Pleural effusionRespiratory, thoracic and mediastinal disorders | 0/30 | 1/28 |
| Event | Serelaxin | Placebo |
|---|---|---|
| HeadacheNervous system disorders | 2/30 | 4/28 |
| Angina pectorisCardiac disorders | 0/30 | 2/28 |
| Haemoglobin decreasedInvestigations | 2/30 | 2/28 |
| DizzinessNervous system disorders | 2/30 | 2/28 |
| AnaemiaBlood and lymphatic system disorders | 0/30 | 1/28 |
| TachycardiaCardiac disorders | 0/30 | 1/28 |
| DyspepsiaGastrointestinal disorders | 0/30 | 1/28 |
| Feeling coldGeneral disorders | 0/30 | 1/28 |
| Influenza like illnessGeneral disorders | 0/30 | 1/28 |
| Lower respiratory tract infectionInfections and infestations | 0/30 | 1/28 |
| Age, Continuous(Years) | Serelaxin | Placebo | Total |
|---|---|---|---|
| Mean | 62.6 ± 6.42 | 60.1 ± 7.05 | 61.4 ± 6.79 |
| Sex: Female, Male(Participants) | Serelaxin | Placebo | Total |
|---|---|---|---|
| Female | 3 | 2 | 5 |
| Male | 27 | 26 | 53 |
Plan to share: Undecided — Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
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