A Phase 2 interventional study of Serelaxin and Placebo in Acute Heart Failure, sponsored by Novartis Pharmaceuticals. Completed at 15 sites in Japan. Open to participants aged 20 Years and older. Per ClinicalTrials.gov, last updated 2015-10-12.
Sponsored by Novartis Pharmaceuticals · Phase 2, Interventional, and Treatment
This is a multicenter, randomized, double-blind, placebo-controlled study to assess safety, tolerability and pharmacokinetics and to explore efficacy of IV infusion of 10 µg/kg/day and 30 µg/kg/day serelaxin for 48 hours compared to placebo, when added to the standard therapy, in approximately 45 Japanese AHF patients.
5,701 studies on the registry are indexed under Heart Failure; 1,220 are open to participants now.
This study's enrollment of 46 is below the median of 72 across 3,736 interventional studies indexed under Heart Failure.
Browse Heart Failure studies →Novartis Pharmaceuticals is the lead sponsor of 2,673 studies on the registry; 228 are open to participants now.
Of its 576 completed or terminated interventional studies of FDA-regulated products, 431 (75%) have results posted.
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Key Inclusion Criteria:
Key Exclusion Criteria:
Participants received 10 mcg/kg/day serelaxin as continuous i.v. infusion for 48 hours.
Drug: Serelaxin
Participants received 30 mcg/kg/day serelaxin as continuous i.v. infusion for 48 hours.
Drug: Serelaxin
Participants received continuous i.v. infusion of placebo matched to serelaxin for 48 hours.
Drug: Placebo
Intravenous infusion
Placebo
Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs and SAEs, AEs Requiring Dose Adjustment or Interruption and Additional Therapy
AEs were defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. SAEs were defined as any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgement of investigators represent significant hazards. AEs leading to discontinuations, or requiring dose adjustment or interruptions and additional therapy were assessed.
Time frame: From start of study treatment up to Day 5 (for AEs); From start of study treatment up to Day 14 (for SAEs)
Maximum Plasma Concentration (Cmax) of Serelaxin
Maximum plasma concentration (Cmax) was defined as the peak level of serelaxin, derived from plasma concentration-time data, using a non-compartmental model approach.
Time frame: Baseline (pre-dose), 1, 2, 24, 48, 49, 52 and 56 hours (post-dose)
Weight Adjusted Clearance (CL) of Serelaxin
Weight adjusted clearance (CL) was defined as the total body clearance of serelaxin after drug administration. CL was calculated as nominal infusion rate divided by Css, using a non-compartmental model approach.
Time frame: Baseline (pre-dose), 1, 2, 24, 48, 49, 52 and 56 hours (post-dose)
Concentration at Steady-state (Css) of Serelaxin
Concentration at steady-state (Css) was defined as concentration at the state of equilibrium obtained at the end of a certain number of administrations. Css of serelaxin in plasma was calculated by using a non-compartmental model approach.
Time frame: Baseline (pre-dose), 1, 2, 24, 48, 49, 52 and 56 hours (post-dose)
Change From Baseline in Area Under the Curve (AUC) for Systolic Blood Pressure (SBP) Through 48 Hours of Infusion at Day 5
The area under the curve (AUC) was defined as area under the plasma concentration-time curve from time zero to time of the last time point with measurable concentration, calculated by a trapezoidal method. Systolic blood pressure was measured using a calibrated standard sphygmomanometer after the subject remained in sitting position for 3 minutes at clinic during the visit. Sample collected at: Baseline; 30 \& 60 minutes and then every hour for the first 6 hours of study drug infusion, and then every 3 hours during 48 hours of study drug infusion; every 3 hours until 12 hours following end of infusion, then every 6 hours for 48 hours and then every 24 hours until the earlier of Day 5 or discharge. AUC for SBP is standardized by dividing by the length of respective time ranges.
Time frame: Baseline, 48 hours, Day 5
Change From Baseline in Aldosterone Levels Through Day 14
Aldosterone biomarker was used to assess the effect of serelaxinin on fluid retention. Geometric means of the ratio of post-Baseline values to baseline values of aldosterone was calculated by treatment for the full analysis set.
Time frame: Baseline, Day 1, Day 2, Day 5, Day 14
Change From Baseline in Cystatin-C Levels Through Day 14
Cystatin-C biomarker was used to assess the effect of serelaxinin on worsening of renal function. Geometric means of the ratio of post-Baseline values to baseline values of Cystatin-C was calculated by treatment for the full analysis set.
Time frame: Baseline, Day 1, Day 2, Day 5, Day 14
Change From Baseline in High Sensitivity Troponin-T Levels Through Day 14
High sensitivity Troponin-T biomarker was used to assess the effect of serelaxin on myocardial damage. Geometric means of the ratio of post-Baseline values to baseline values of high sensitivity troponin-t was calculated by treatment for the full analysis set.
Time frame: Baseline, Day 1, Day 2, Day 5, Day 14
Change From Baseline in NT-proBNP Levels Through Day 14
NT-proBNP biomarker was used to assess the effect of serelaxinin on degree of cardiac wall stress and congestion. Geometric means of the ratio of post-Baseline values to baseline values of NT-proBNP was calculated by treatment for the full analysis set.
Time frame: Baseline, Day 1, Day 2, Day 5, Day 14
Change From Baseline in Neutrophil Gelatinase-asc Lipocalin (NGAL) Levels Through Day 14
Neutrophil gelatinase-asc lipocalin (NGAL) biomarker was used to assess the effect of serelaxin on kidney function. Geometric means of the ratio of post-Baseline values to baseline values of NGAL was calculated by treatment for the full analysis set.
Time frame: Baseline, Day 1, Day 2, Day 5, Day 14
The study was conducted at 15 centers in Japan.
| Milestone | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo |
|---|---|---|---|
| Started | 16 | 15 | 15 |
| Completed | 16 | 15 | 15 |
| Not completed | 0 | 0 | 0 |
AEs were defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. SAEs were defined as any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgement of investigators represent significant hazards. AEs leading to discontinuations, or requiring dose adjustment or interruptions and additional therapy were assessed.
| participants | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo |
|---|---|---|---|
| AEs | 10 | 11 | 9 |
| SAEs | 1 | 3 | 0 |
| Death | 0 | 0 | 0 |
| Discontinuation due to AE(s) | 0 | 2 | 0 |
| Discontinuation due to SAE(s) | 0 | 0 | 0 |
| AEs requiring dose adjustment or interruption | 0 | 1 | 0 |
| AEs requiring additional therapy | 8 | 10 | 9 |
| AEs related to study drug | 2 | 2 | 0 |
Maximum plasma concentration (Cmax) was defined as the peak level of serelaxin, derived from plasma concentration-time data, using a non-compartmental model approach.
| nanogram(s)/milliliter (ng/mL) | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day |
|---|---|---|
| Maximum Plasma Concentration (Cmax) of Serelaxin | 8.01 ± 2.07 | 19.2 ± 4.69 |
Weight adjusted clearance (CL) was defined as the total body clearance of serelaxin after drug administration. CL was calculated as nominal infusion rate divided by Css, using a non-compartmental model approach.
| mL/hr/kg | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day |
|---|---|---|
| Weight Adjusted Clearance (CL) of Serelaxin | 56.8 ± 15.4 | 70.2 ± 23.2 |
Concentration at steady-state (Css) was defined as concentration at the state of equilibrium obtained at the end of a certain number of administrations. Css of serelaxin in plasma was calculated by using a non-compartmental model approach.
| ng/mL | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day |
|---|---|---|
| Concentration at Steady-state (Css) of Serelaxin | 7.81 ± 1.96 | 19.1 ± 4.61 |
The area under the curve (AUC) was defined as area under the plasma concentration-time curve from time zero to time of the last time point with measurable concentration, calculated by a trapezoidal method. Systolic blood pressure was measured using a calibrated standard sphygmomanometer after the subject remained in sitting position for 3 minutes at clinic during the visit. Sample collected at: Baseline; 30 \& 60 minutes and then every hour for the first 6 hours of study drug infusion, and then every 3 hours during 48 hours of study drug infusion; every 3 hours until 12 hours following end of infusion, then every 6 hours for 48 hours and then every 24 hours until the earlier of Day 5 or discharge. AUC for SBP is standardized by dividing by the length of respective time ranges.
| mmHg | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo |
|---|---|---|---|
| 48 hours | -8.21 ± 2.903 | -18.6 ± 3.018 | -10.88 ± 3.018 |
| Day 5 | -8.79 ± 2.761 | -22.14 ± 2.871 | -14.77 ± 2.871 |
Aldosterone biomarker was used to assess the effect of serelaxinin on fluid retention. Geometric means of the ratio of post-Baseline values to baseline values of aldosterone was calculated by treatment for the full analysis set.
| Ratio | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo |
|---|---|---|---|
| Day 1 | 0.985 (0.7636 to 1.2717) | 0.816 (0.6118 to 1.0897) | 0.791 (0.6374 to 0.9825) |
| Day 2 | 0.975 (0.7492 to 1.2685) | 0.721 (0.5195 to 0.9999) | 0.911 (0.7141 to 1.1620) |
| Day 5 | 0.895 (0.6327 to 1.2656) | 0.825 (0.6468 to 1.0531) | 0.816 (0.5352 to 1.2452) |
| Day 14 | 1.510 (0.9934 to 2.2962) | 1.114 (0.7983 to 1.5555) | 1.179 (0.8337 to 1.6661) |
Cystatin-C biomarker was used to assess the effect of serelaxinin on worsening of renal function. Geometric means of the ratio of post-Baseline values to baseline values of Cystatin-C was calculated by treatment for the full analysis set.
| Ratio | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo |
|---|---|---|---|
| Day 1 | 0.921 (0.8863 to 0.9565) | 0.988 (0.9213 to 1.0598) | 0.985 (0.9291 to 1.0450) |
| Day 2 | 0.930 (0.8736 to 0.9900) | 0.852 (0.6465 to 1.1236) | 0.965 (0.9002 to 1.0346) |
| Day 5 | 1.062 (0.9898 to 1.1384) | 1.115 (1.0207 to 1.2178) | 1.038 (0.9627 to 1.1194) |
| Day 14 | 1.195 (1.0154 to 1.4057) | 1.136 (1.0348 to 1.2472) | 1.125 (1.0313 to 1.2271) |
High sensitivity Troponin-T biomarker was used to assess the effect of serelaxin on myocardial damage. Geometric means of the ratio of post-Baseline values to baseline values of high sensitivity troponin-t was calculated by treatment for the full analysis set.
| Ratio | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo |
|---|---|---|---|
| Day 1 | 0.899 (0.7598 to 1.0643) | 1.060 (0.8932 to 1.2572) | 0.956 (0.8652 to 1.0559) |
| Day 2 | 0.856 (0.6935 to 1.0553) | 1.040 (0.8514 to 1.2714) | 0.894 (0.7650 to 1.0442) |
| Day 5 | 0.849 (0.5984 to 1.2044) | 0.972 (0.7779 to 1.2151) | 0.779 (0.5250 to 1.1572) |
| Day 14 | 0.820 (0.5729 to 1.1730) | 0.813 (0.4480 to 1.4748) | 0.685 (0.4652 to 1.0093) |
NT-proBNP biomarker was used to assess the effect of serelaxinin on degree of cardiac wall stress and congestion. Geometric means of the ratio of post-Baseline values to baseline values of NT-proBNP was calculated by treatment for the full analysis set.
| Ratio | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo |
|---|---|---|---|
| Day 1 | 0.585 (0.4356 to 0.7865) | 0.646 (0.5146 to 0.8115) | 0.673 (0.5416 to 0.8363) |
| Day 2 | 0.492 (0.3421 to 0.7076) | 0.451 (0.3271 to 0.6210) | 0.581 (0.4410 to 0.7656) |
| Day 5 | 0.388 (0.2502 to 0.6028) | 0.386 (0.2575 to 0.5796) | 0.526 (0.3685 to 0.7503) |
| Day 14 | 0.295 (0.1649 to 0.5293) | 0.419 (0.2621 to 0.6691) | 0.277 (0.1875 to 0.4079) |
Neutrophil gelatinase-asc lipocalin (NGAL) biomarker was used to assess the effect of serelaxin on kidney function. Geometric means of the ratio of post-Baseline values to baseline values of NGAL was calculated by treatment for the full analysis set.
| Ratio | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo |
|---|---|---|---|
| Day 1 | 1.011 (0.8911 to 1.1478) | 1.083 (0.9025 to 1.2996) | 1.054 (0.9574 to 1.1613) |
| Day 2 | 0.929 (0.8443 to 1.0229) | 1.172 (0.9994 to 1.3736) | 1.099 (0.9866 to 1.2236) |
| Day 5 | 1.129 (1.0145 to 1.2560) | 1.238 (1.0139 to 1.5114) | 1.135 (1.0141 to 1.2698) |
| Day 14 | 1.434 (1.1760 to 1.7489) | 1.520 (1.3214 to 1.7485) | 1.433 (1.1793 to 1.7401) |
Collected over Adverse events are collected from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV). All adverse events reported in this record are from date of First Patient First Treatment until Last Patient Last Visit. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Serelaxin 10 mcg/kg/Day | — | 1/16 (6.3%) | 10/16 (62.5%) |
| Serelaxin 30 mcg/kg/Day | — | 3/15 (20%) | 9/15 (60%) |
| Placebo | — | 0/15 (0%) | 9/15 (60%) |
| Event | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo |
|---|---|---|---|
| CARDIAC FAILURECardiac disorders | 0/16 | 1/15 | 0/15 |
| CORONARY ARTERY STENOSISCardiac disorders | 0/16 | 1/15 | 0/15 |
| VENTRICULAR TACHYCARDIACardiac disorders | 0/16 | 1/15 | 0/15 |
| INTESTINAL ISCHAEMIAGastrointestinal disorders | 0/16 | 1/15 | 0/15 |
| GASTRIC CANCERNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/16 | 1/15 | 0/15 |
| METASTASES TO LIVERNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/16 | 1/15 | 0/15 |
| METASTASES TO LYMPH NODESNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/16 | 1/15 | 0/15 |
| METASTASES TO PERITONEUMNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/16 | 1/15 | 0/15 |
| OESOPHAGEAL CARCINOMANeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/16 | 1/15 | 0/15 |
| ATRIAL FIBRILLATIONCardiac disorders | 1/16 | 0/15 | 0/15 |
| Event | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo |
|---|---|---|---|
| CONSTIPATIONGastrointestinal disorders | 0/16 | 4/15 | 1/15 |
| CARDIAC FAILURECardiac disorders | 0/16 | 1/15 | 3/15 |
| HYPOKALAEMIAMetabolism and nutrition disorders | 0/16 | 2/15 | 2/15 |
| IRON DEFICIENCY ANAEMIABlood and lymphatic system disorders | 0/16 | 0/15 | 1/15 |
| ATRIAL FIBRILLATIONCardiac disorders | 0/16 | 0/15 | 1/15 |
| VENTRICULAR TACHYCARDIACardiac disorders | 0/16 | 1/15 | 0/15 |
| NAUSEAGastrointestinal disorders | 0/16 | 0/15 | 1/15 |
| BACTERIAL INFECTIONInfections and infestations | 0/16 | 0/15 | 1/15 |
| INFECTIONInfections and infestations | 0/16 | 0/15 | 1/15 |
| INFLUENZAInfections and infestations | 0/16 | 1/15 | 0/15 |
The analysis was performed on safety population defined as all randomized participants received any amount of study drug and had at least one post-baseline safety assessment.
| Age, Continuous(years) | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo | Total |
|---|---|---|---|---|
| Mean | 70.2 ± 11.77 | 79.7 ± 9.01 | 76.4 ± 12.08 | 75.3 ± 11.54 |
| Age, Customized(participants) | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo | Total |
|---|---|---|---|---|
| < 65 years | 6 | 1 | 3 | 10 |
| ≥ 65 years | 10 | 14 | 12 | 36 |
| Sex: Female, Male(Participants) | Serelaxin 10 mcg/kg/Day | Serelaxin 30 mcg/kg/Day | Placebo | Total |
|---|---|---|---|---|
| Female | 4 | 5 | 3 | 12 |
| Male | 12 | 10 | 12 | 34 |
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Novartis Pharmaceuticals