Completed Heart, Stroke & Blood NIHR-supported project Brain & Nervous System

A Phase 2, Randomized, Double-Blind, Placebo-Controlled Clinical Study to Assess the Safety and Effectiveness of Tovinontrine in Patients With Chronic Heart Failure With Preserved Ejection Fraction

In plain English

AI plain-English summary

A new clinical trial is testing whether a daily 50 mg pill of tovinontrine can lower a key heart-stress marker in patients with a common form of heart failure that currently has few treatment options. This matters because chronic heart failure with preserved ejection fraction (HFpEF) affects roughly half of all heart failure patients, yet no drug has been proven to reliably improve outcomes. The standard biomarker for heart strain—NT-proBNP—often rises in these patients even when they are on existing medications. Tovinontrine works by inhibiting the PDE9 enzyme, a mechanism similar to the approved drug Entresto, but targets a different part of the cellular signalling pathway. If the trial shows that tovinontrine significantly reduces NT-proBNP levels over 12 weeks compared to placebo, it would provide strong evidence that PDE9 inhibitors can relieve cardiac stress in HFpEF. That could open the door to larger Phase 3 studies and eventually a new treatment option for millions of patients who currently have no targeted therapy. Even if the drug fails to show benefit, the trial will generate rigorous data on how NT-proBNP behaves in HFpEF under controlled conditions, helping refine future trial designs.

View original technical description
This is a Phase 2, study to study the safety and efficacy of 50 mg of tovinontrine in adult patients with Chronic Heart Failure With Preserved Ejection Fraction (HFpEF). The primary endpoint (measurement of what happens to people in the clinical trial) will assess the change in NT-proBNP blood level over 12 weeks compared to placebo. NT-proBNP level in blood is an indicator (biomarker) of effectiveness of the treatment. NT-proBNP has been used as a biomarker in other Phase 2 HF studies, including those testing a drug available on the market called Entresto, working in a similar way in the body as tovinontrine.There is a sound scientific and medical rationale for the development of PDE9 inhibitors (such as tovinotrine) for HF. Nevertheless, there may not be any clinical benefit from taking part in this research study. However, the results of this research will benefit science and may guide the future treatment of patients with HF. The study will include a placebo arm (sham treatment). A placebo arm is considered necessary because NT-proBNP may change during the course of the study without additional drug intervention, and therefore, an objective comparison of the effect of each tovinontrine dose level with placebo-treated patients is necessary. Further, to ensure adequate treatment for study patients, standard-of-care medications for HF treatment are not excluded during study participation. Taking into account the measures taken to mitigate risk to patients in this study, the potential risks identified in association with tovinontrine are justified by the anticipated potential benefits that may be afforded to patients with HFpEF.

Researchers

Peter Cowburn (Principal Investigator)

Related Research

Grants with similar aims, by meaning.

CRD-750-202 - A Phase 2, Randomized, Double-Blind, Placebo-Controlled Clinical Study to Assess the Safety and Effectiveness of Tovinontrine in Patients With Chronic Heart Failure With Preserved Ejection Fraction
A Phase 2, Randomized, Double-Blind, Placebo-Controlled,Dose-Finding Study to Assess the Safety and Effectiveness of Tovinontrine in Patients With Chronic Heart Failure With Reduced Ejection Fraction
A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Dose-Finding Study to Assess the Safety and Effectiveness of Tovinontrine in Patients With Chronic Heart Failure With Reduced Ejection Fraction
CRD-750-202? A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Clinical Study to Assess the Effectiveness of Tovinontrine in Patients with Chronic Heart Failure with Preserved Ejection Fraction (HFpEF)
CRD-750-201 - A Phase 2, Randomized, Double-Blind, Placebo-Controlled Clinical Study to Assess the Safety and Effectiveness of Tovinontrine in Patients With Chronic Heart Failure With Preserved Ejection Fraction

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