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CompletedNCT06215911Cycle-1-REFUpdated Sep 1, 2026

A Study to Assess Safety & Effectiveness of Tovinontrine in Chronic Heart Failure With Reduced Ejection Fraction (Cycle-1-REF)

A Phase 2 interventional study of Tovinontrine (CRD-750) and Placebo in Heart Failure, Heart Failure With Reduced Ejection Fraction and Cardiovascular Diseases, sponsored by Cardurion Pharmaceuticals, Inc.. Completed at 139 sites in 19 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-01.

Sponsored by Cardurion Pharmaceuticals, Inc. · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was Oct 2025, 1 year 1 month ago, and no results have been posted to the registry; the sponsor requested a delay in submitting them in Aug 2026.
Phase
Phase 2
Study type
Interventional
Enrollment
557
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to evaluate the safety and effectiveness of tovinontrine compared to placebo to lower NT-proBNP in patients with chronic heart failure with reduced ejection fraction.

02

Conditions studied

  • Heart Failure
  • Heart Failure With Reduced Ejection Fraction
  • Cardiovascular Diseases
  • Heart Diseases

Keywords

  • PDE9
  • PED9 Inhibitor
  • Heart Failure
  • CRD-750
  • Tovinontrine
  • HFrEF
03

In context

Heart Failure

6,331 studies on the registry are indexed under Heart Failure; 1,396 are open to participants now.

This study's enrollment of 557 is above the median of 76 across 4,049 interventional studies indexed under Heart Failure.

Browse Heart Failure studies →

Lead sponsor

Cardurion Pharmaceuticals, Inc. is the lead sponsor of 12 studies on the registry; 2 are open to participants now.

Of its 8 completed or terminated interventional studies of FDA-regulated products, 4 (50%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Is an adult male or female patient ≥18 years of age
  • Has evidence in the medical history supporting a diagnosis of clinical HF syndrome, functional class II to III, with the duration of at least 6 months prior to the time of Screening. The HF syndrome is defined by documentation of 1 or more of the following:

    • At least 1 of the typical symptoms due to HF such as dyspnea and/or fatigue limiting exercise capacity;
    • At least 1 of the typical signs of HF such as peripheral edema, elevated jugular venous pressure, pulmonary crackles; or
    • Hospitalization, emergency department visit, or outpatient visit for HF requiring intravenous (IV) or subcutaneous (SQ) diuresis within the past 12 months.
  • Has (EF) ≤ 40% by transthoracic echocardiogram (TTE) performed and interpreted locally at the time of Screening;
  • Has NT-proBNP level ≥ 600 pg/mL at the time of Screening. Patients with atrial fibrillation or flutter at the time of Screening are required to have an NT-proBNP level of ≥ 1000 pg/mL at the time of Screening;
  • Is on stable optimized doses of guideline-directed HF therapy, per Investigator's clinical judgement, for a minimum of 4 weeks prior to the time of Screening and during Screening, with no planned changes after randomization.
  • Has had no addition of new guideline-directed HF therapy within the 3 months prior to the time of Screening or during the Screening Period;

Exclusion criteria

Exclusion Criteria:

  • Has a documented EF >40% by TTE within 6 months of the time of Screening or during the Screening Period;
  • Has evidence of recent HF exacerbation defined by hospitalization or requirement for IV or SQ diuretics within 60 days of the time of Screening or during the Screening Period;
  • Has a requirement for routine, scheduled outpatient IV infusions for HF (ie, inotropes, vasodilators, or diuretics) or routinely scheduled ultrafiltration;
  • Has elective interventions (eg, percutaneous coronary intervention, device implantations, percutaneous structural heart disease interventions, cardiac and non-cardiac surgery) planned to occur during involvement in this study;
  • Has acute coronary syndrome, stroke, , cardiac, carotid or other major cardiovascular surgery, or carotid angioplasty within 60 days of the time of Screening or during the Screening Period;
  • Has had a prior or planned orthotopic heart transplantation;
  • Has presence of or plan for mechanical circulatory support;

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
557 participants (actual)

Study arms

  • Experimental
    Tovinontrine (CRD-750) - low dose

    Drug: Tovinontrine (CRD-750)

  • Experimental
    Tovinontrine (CRD-750) - medium dose

    Drug: Tovinontrine (CRD-750)

  • Experimental
    Tovinontrine (CRD-750) - high dose

    Drug: Tovinontrine (CRD-750)

  • Placebo comparator
    Placebo

    Drug: Placebo

Interventions

06

What researchers measure

Primary outcomes

  1. Change in biomarkers from Baseline to Week 12 - NT-proBNP by treatment group

    The percent change in plasma NT-proBNP from Baseline to Week 12.

    Time frame: Baseline to Week 12

Secondary outcomes

  1. Change in biomarkers at Week 12 - NT-proBNP

    The percent change in plasma NT-proBNP will be calculated from Baseline to Week 12. The correlation of plasma concentration with percent change in plasma NT-proBNP will be evaluated.

    Time frame: Baseline to Week 12

  2. Change in biomarkers at week 12 by treatment group - cGMP

    The percent change in urine and plasma cGMP from Baseline to Week 12.

    Time frame: Baseline to Week 12

  3. Change in biomarkers at week 12 by treatment group - BNP

    The percent change in BNP from Baseline to Week 12.

    Time frame: Baseline to Week 12

  4. Change in the biomarker ratio at Week 12 - NT-proBNP

    The percent change in the urine and plasma cGMP to NT-proBNP ratio at week 12

    Time frame: Baseline to Week 12

  5. Change in the biomarker ratio at Week 12 - BNP

    The percent change in the urine and plasma cGMP to BNP ratio from Baseline to Week 12

    Time frame: Baseline to Week 12

  6. The change from baseline in the Kansas City Cardiomyopathy Questionnaire-23-Clinical Summary Score

    Scaled 0 to 100 where lower scores represent worse health status than higher scores

    Time frame: Baseline to Week 12

  7. The change from baseline in the Kansas City Cardiomyopathy Questionnaire 23- Overall Summary Score

    Scaled 0 to 100 where lower scores represent worse health status than higher scores

    Time frame: Baseline to Week 12

  8. The change from baseline in the Kansas City Cardiomyopathy Questionnaire-23-CSS - Categorical

    The proportion of patients with \>=5, 10 and 20-point improvement in the KCCQ-23-CSS.

    Time frame: Week 12

  9. New York Heart Association Classification

    Class I to IV are possible with a higher classification representing worsening heart failure status.

    Time frame: Week 12

  10. Treatment Emergent Adverse Events (TEAEs)

    The number of participants with TEAEs including drug related AEs, serious AEs (SAEs), and AEs leading to study drug discontinuation.

    Time frame: Baseline to Week 12

07

Study locations

139 sites
  • Cardurion Investigative Site
    Birmingham, Alabama 35233, United States
  • Cardurion Investigative Site
    Little Rock, Arkansas 72204, United States
  • Cardurion Investigative Site
    Beverly Hills, California 90211, United States
  • Cardurion Investigative Site
    Orange, California 92868, United States
  • Cardurion Investigative Site
    Torrance, California 90502, United States
  • Cardurion Investigative Site
    Van Nuys, California 91405, United States
  • Cardurion Investigative Site
    Jacksonville, Florida 32216, United States
  • Cardurion Investigative Site
    Miami, Florida 33137, United States
  • Cardurion Investigative Site
    Hazel Crest, Illinois 60429, United States
  • Cardurion Investigative Site
    Peoria, Illinois 61636, United States
  • Cardurion Investigative Site
    Alexandria, Louisiana 71301, United States
  • Cardurion Investigative Site
    Covington, Louisiana 70433, United States
  • Cardurion Investigative Site
    Baltimore, Maryland 21201, United States
  • Cardurion Investigative Site
    St Louis, Missouri 63110, United States
  • Cardurion Investigative Site
    Omaha, Nebraska 68198, United States
  • Cardurion Investigative Site
    Buffalo, New York 14215, United States
  • Cardurion Investigative Site
    New York, New York 10025, United States
  • Cardurion Investigative Site
    Cleveland, Ohio 44195, United States
  • Cardurion Investigative Site
    Oklahoma City, Oklahoma 73135, United States
  • Cardurion Investigative Site
    Rapid City, South Dakota 57701, United States
  • Cardurion Investigative Site
    Nashville, Tennessee 37232, United States
  • Cardurion Investigative Site
    Dallas, Texas 75226, United States
  • Cardurion Investigative Site
    McKinney, Texas 75069, United States
  • Cardurion Investigative Site
    Burlington, Vermont 05401, United States
  • Cardurion Investigative Site
    Seattle, Washington 98195, United States
  • Cardurion Investigative Site
    Madison, Wisconsin 53792, United States
  • Cardurion Investigative Site
    Southport, Queensland 4222, Australia
  • Cardurion Investigative Site
    Chermside, 4032, Australia
  • Cardurion Investigative Site
    Perth, Australia
  • Cardurion Investigational Site
    Bruges, 8000, Belgium
  • Cardurion Investigative Site
    Brussels, 1070, Belgium
  • Cardurion Investigative Site
    Brussels, Belgium
  • Cardurion Investigative Site
    Genk, Belgium
  • Cardurion Investigative Site
    Ghent, 9000, Belgium
  • Cardurion Investigative Site
    Hasselt, 3500, Belgium
  • Cardurion Investigative Site
    Kortrijk, 8500, Belgium
  • Cardurion Investigative Site
    Sint-Niklaas, 9100, Belgium
  • Cardurion Investigative Site
    Burgas, 8008, Bulgaria
  • Cardurion Investigative Site
    Gabrovo, 5300, Bulgaria
  • Cardurion Investigative Site
    Pazardzhik, 4400, Bulgaria
  • Cardurion Investigative Site
    Plovdiv, 4002, Bulgaria
  • Cardurion Investigative Site
    Plovdiv, 4003, Bulgaria
  • Cardurion Investigative Site
    Rousse, 7000, Bulgaria
  • Cardurion Investigative Site
    Sofia, 1000, Bulgaria
  • Cardurion Investigative Site 2
    Sofia, 1233, Bulgaria
  • Cardurion Investigative Site
    Sofia, 1233, Bulgaria
  • Cardurion Investigative Site
    Stara Zagora, 6000, Bulgaria
  • Cardurion Investigative Site
    Veliko Tarnovo, 5006, Bulgaria
  • Cardurion Investigative Site
    Cambridge, Ontario N1R 6V6, Canada
  • Cardurion Investigative Site
    Hamilton, Ontario L8L 2X2, Canada
  • Cardurion Investigative Site
    Chicoutimi, Quebec G7H 7K9, Canada
  • Cardurion Investigative Site
    Montreal, Quebec, Canada
  • Cardurion Investigative Site
    Sherbrooke, J1G 2E8, Canada
  • Cardurion Investigative Site
    Trois-Rivières, G9B 2N3, Canada
  • Cardurion Investigative Site
    Hradec Králové, 500 02, Czechia
  • Cardurion Investigative Site
    Hradec Králové, 500 05, Czechia
  • Cardurion Investigative Site
    Prague, 128 08, Czechia
  • Cardurion Investigative Site
    Tbilisi, 0102, Georgia
  • Cardurion Investigative Site
    Tbilisi, 0131, Georgia
  • Cardurion Investigative Site
    Tbilisi, 0141, Georgia
  • Cardurion Investigative Site 2
    Tbilisi, 0159, Georgia
  • Cardurion Investigative Site
    Tbilisi, 0159, Georgia
  • Cardurion Investigative Site
    Tbilisi, 0160, Georgia
  • Cardurion Investigative Site
    Tbilisi, 0186, Georgia
  • Cardurion Investigative Site
    Berlin, Brandenburg 10787, Germany
  • Cardurion Investigative Site
    Elsterwerda, Brandenburg 04910, Germany
  • Cardurion Investigative Site
    Papenburg, Lower Saxony 26871, Germany
  • Cardurion Investigative Site
    Dresden, 01067, Germany
  • Cardurion Investigative Site
    Magdeburg, 39120, Germany
  • Cardurion Investigative Site
    Balatonfüred, 8230, Hungary
  • Cardurion Investigative Site
    Budapest, 1148, Hungary
  • Cardurion Investigative Site
    Budapest, H-1122, Hungary
  • Cardurion Investigative Site
    Gyöngyös, 3200, Hungary
  • Cardurion Investigative Site
    Hatvan, 3000, Hungary
  • Cardurion Investigative Site
    Kaposvár, 7400, Hungary
  • Cardurion Investigative Site
    Orosháza, 5900, Hungary
  • Cardurion Investigative Site
    Zalaegerszeg, 8900, Hungary
  • Cardurion Investigative Site
    Bergamo, Italy
  • Cardurion Investigative Site
    Milan, 20138, Italy
  • Cardurion Investigative Site
    Naples, Italy
  • Cardurion Investigative Site
    Rozzano, Italy
  • Cardurion Investigative Site
    Riga, Latvia
  • Cardurion Investigative Site
    Kaunas, Lithuania
  • Cardurion Investigative Site
    Klaipėda, Lithuania
  • Cardurion Investigative Site
    Panevezys, Lithuania
  • Cardurion Investigative Site
    Goes, 4462 RA, Netherlands
  • Cardurion Investigative Site
    Groningen, 9713 GZ, Netherlands
  • Cardurion Investigative Site
    Hardenberg, 7772 SE, Netherlands
  • Cardurion Investigative Site
    Sneek, 8601 ZR, Netherlands
  • Cardurion Investigative Site
    The Hague, 2545 AA, Netherlands
  • Cardurion Investigative Site
    Utrecht, 3582 KE, Netherlands
  • Cardurion Investigative Site
    Veldhoven, 5504 DB, Netherlands
  • Cardurion Investigative Site
    Zutphen, 7207 AE, Netherlands
  • Cardurion Investigative Site
    Christchurch, New Zealand
  • Cardurion Investigative Site
    Dunedin, New Zealand
  • Cardurion Investigative Site
    Grodzisk Mazowiecki, 05-825, Poland
  • Cardurion Investigative Site
    Krakow, 31-216, Poland
  • Cardurion Investigative Site
    Lodz, 92-213, Poland
  • Cardurion Investigative Site
    Lodz, 94-255, Poland
  • Cardurion Investigative Site
    Lodz, Poland

Showing the first 100 of 139 sites across 19 countries. Choose a country and city above to see the rest.

08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 1, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06215911
Lead sponsor
Cardurion Pharmaceuticals, Inc.
Responsible party
Sponsor
First posted
Jan 22, 2024
Start date
Feb 13, 2024
Primary completion
Oct 10, 2025
Completion
Oct 10, 2025
Last update
Sep 1, 2026

Study contacts

Gail Berman
study director · Senior VP Head, Clinical Development Cardurion

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Tovinontrine

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