Pulmonary HypertensionPhase 2SPHERE-HFNCT02775539
Beta3 Agonist Treatment in Chronic Pulmonary Hypertension Secondary to Heart Failure
A Phase 2 study testing Mirabegron in people with Pulmonary Hypertension and Mirabegron, run by Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III.
Trial summary
The purpose of this study is to evaluate the efficacy and safety of mirabegron (a B3 adrenergic receptor agonist) in patients with pulmonary hypertension secondary to heart failure by conducting a randomized multicenter phase II placebo-controlled clinical trial. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Pulmonary Hypertension, Mirabegron, Heart Failure
- What is being tested?
- Mirabegron
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 80 participants
- Where
- No sites listed yet
- Study dates
- Jun 2016to Jun 2019
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Written inform consent;
- >18 years-old;
- HF with reduced or preserved ejection fraction, according to the definition of the European Society of Cardiology guidelines.
- Severe PH and/or combined postcapillary and precapillary PH (also knows as reactive or out-of-proportion PH) determined by RHC showing the following:
- Pulmonary arterial wedge pressure or end-diastolic left ventricular pressures ≥15 mmHg;
- Mean PAP≥25, and:
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- PVR≥3 UW and/or diastolic gradient≥7 mmHg or
- Transpulmonary gradient≥12.
- NYHA functional class II-IV;
- On optimized evidence-based pharmacological treatment;
- Stable clinical condition defined as no changes in therapeutic regimen or hospitalization in the 30 days preceding recruitment and no current plan for changing therapy.
Who cannot join
- Non-coronary cardiac surgery or non-coronary percutaneous procedure within the 12 months preceding recruitment or programmed;
- Myocardial infarction or coronary revascularization during the last 3 months,
- Myocardial resynchronization therapy initiated during the last 6 months;
- Sinus tachycardia or atrial fibrillation with uncontrolled heart rate (>100 bpm);
- Uncontrolled hypertension (PAS>180 or PAD>110 mmHg) or symptomatic hypotension (PAS<90 mmHg).
- Infiltrative myocardial disease.
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- Expected survival <1 year due to a disease other than PH;
- Severe renal failure (GFR <30 mL/min/1.73 m2 or haemodialysis);
- Severe hepatic impairment (serum aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) >3x the upper limit of normality at screening;
- cQT interval on the ECG >430 ms in male or >450 ms in female;
- Concomitant use of specific pulmonary vasodilator therapy (i.e. endothelin receptor antagonists, phosphodiesterase -5 inhibitors, guanylate cyclase stimulators).
- Concomitant use of digoxin, flecainide, propafenone, dabigatran, tricycle antidepressants, or another strong inhibitors of CYP2D6 (with the exception of betablockers).
- Significant obstructive lung disease (FEV1/FVC<0.7 associated with FEV1<50% of predicted value).
- Significant restrictive lung disease (TLC<60%).
- Participation in another clinical trial.
- Female with childbearing potential.
- Known hypersensitivity to mirabegron or to any of its excipients.
Trial locations and contacts
No sites are listed yet.
About this study
Official title: Beta3 Adrenergic Agonist Treatment in Chronic Pulmonary Hypertension Secondary to Heart Failure
The purpose of this study is to evaluate the efficacy and safety of mirabegron (a B3 adrenergic receptor agonist) in patients with pulmonary hypertension secondary to heart failure by conducting a randomized multicenter phase II placebo-controlled clinical trial.
Read the detailed description
Pulmonary hypertension (PH) affects 60-80% of patients with chronic heart failure (HF) and has a critical impact on prognosis. Currently, there is no specific treatment approved for this indication. Experimental research, performed by members of the consortium, demonstrates that treatment with B3 adrenergic receptor agonists produces a beneficial effect on pulmonary hemodynamics, right ventricular (RV) remodeling and pulmonary vascular proliferation in a translational pig model of postcapillary PH. Mirabegron, an oral B3AR agonist, is currently approved for a different medical condition (overactive bladder syndrome) with a good safety profile. Our main objective is to evaluate the efficacy and safety of mirabegron in patients with PH secondary to HF.
The objective will be evaluated by conducting a phase-2 randomized placebo-controlled clinical trial in patients with PH associated to HF. Patients will be randomized 1:1 to mirabegron or placebo, and dose will be titrated till 200 mg/day. Patients will be evaluated with quality of life questionnaire, blood analysis, ECG, echocardiography, 6-minute walking test, right heart catheterization (RHC) and cardiac magnetic resonance (CMR) at baseline and after 16 weeks of treatment.
- Conditions
- Pulmonary Hypertension, Mirabegron, Heart Failure, Pulmonary Vascular Resistance Abnormality
- Being tested
- Mirabegron, Placebo
- Keywords
- Pulmonary hypertension, Mirabegron, Heart failure, B3 adrenergic
- Medical subject headings
- Hypertension, Pulmonary, Heart Failure
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
MirabegronDrug
Patients will receive 50 to 200 mg of mirabegron once a day during 16 weeks. Dose will be titrated during the first 8 weeks.
PlaceboDrug
| Study group | Role | What they receive |
|---|---|---|
| Mirabegron | Active comparator | Oral mirabegron, starting with 50 mg once a day and titrated till a maximum of 200 mg once a day. Receives: Drug: Mirabegron |
| Placebo | Placebo comparator | Oral placebo, similarly titrated to ensure blindness. Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in pulmonary vascular resistance (PVR) from baseline to week 16 assessed by right heart catheterization (RHC).
Measured: 16 weeks
Secondary outcomes (14)
Change from baseline in 6-minute walking distance
Measured: 16 weeks
Change from baseline in NYHA functional class
Measured: 16 weeks
Change from baseline in quality of life
Measured: 16 weeks
Change from baseline in dyspnea Borg score
Measured: 16 weeks
Change from baseline in mean PAP as assessed by RHC
Measured: 16 weeks
Change from baseline in cardiac index (CI) as assessed by RHC and cardiac magnetic resonance (CMR)
Measured: 16 weeks
Change from baseline in RV ejection fraction as assessed by CMR
Measured: 16 weeks
Change from baseline in BNP/NT-proBNP
Measured: 16 weeks
Hospital admissions due to worsening cardiopulmonary status
Measured: 16 weeks
Mortality
Measured: 16 weeks
Urgent heart transplantation
Measured: 16 weeks
New onset arrhythmia
Measured: 16 weeks
Need for initiation of intravenous therapy due to worsening HF
Measured: 16 weeks
Adverse drug effects
Measured: 16 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 May 2016 (estimated)
- Study startJun 2016
- Primary completionJan 2017 (estimated)
- Study completionJun 2019 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Pulmonary HypertensionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 80 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III
- Sponsor type
- University, hospital or other
- Collaborators
- Hospital Clinic of Barcelona, Hospital Universitario 12 de Octubre, Puerta de Hierro University Hospital, Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02775539
- Sponsor's protocol ID
- SPHERE-HF
- Acronym
- SPHERE-HF
- Status last verified
- May 2016
- First submitted
- 14 May 2016
- Last updated
- 17 May 2016
- Results posted
- No
- Data monitoring committee
- Yes
- Individual data sharing
- Undecided
Publications
Garcia-Lunar I, Blanco I, Fernandez-Friera L, Prat-Gonzalez S, Jorda P, Sanchez J, Pereda D, Pujadas S, Rivas M, Sole-Gonzalez E, Vazquez J, Blazquez Z, Garcia-Picart J, Caravaca P, Escalera N, Garcia-Pavia P, Delgado J, Segovia-Cubero J, Fuster V, Roig E, Barbera JA, Ibanez B, Garcia-Alvarez A. Design of the beta3-Adrenergic Agonist Treatment in Chronic Pulmonary Hypertension Secondary to Heart Failure Trial. JACC Basic Transl Sci. 2020 Mar 11;5(4):317-327. doi: 10.1016/j.jacbts.2020.01.009. eCollection 2020 Apr.
PubMed 32368692
Study at a glance
From the registry record, last updated by the sponsor on 17 May 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Beta3 Adrenergic Agonist Treatment in Chronic Pulmonary Hypertension Secondary to Heart Failure
- ClinicalTrials.gov ID
- NCT02775539
- Acronym / sponsor ID
- SPHERE-HF / SPHERE-HF
- Conditions
- Pulmonary Hypertension, Mirabegron, Heart Failure, Pulmonary Vascular Resistance Abnormality
- Keywords
- Pulmonary hypertension, Mirabegron, Heart failure, B3 adrenergic
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 80 participants (estimated)
- Lead sponsor
- Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos IIIUniversity, hospital or other
- Collaborators
- Hospital Clinic of Barcelona, Hospital Universitario 12 de Octubre, Puerta de Hierro University Hospital, Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
- Study start
- Jun 2016
- Primary completion
- Jan 2017 (estimated)
- Study completion
- Jun 2019 (estimated)
- First posted
- 17 May 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to evaluate the efficacy and safety of mirabegron (a B3 adrenergic receptor agonist) in patients with pulmonary hypertension secondary to heart failure by conducting a randomized multicenter phase II placebo-controlled clinical trial.
Detailed description
Pulmonary hypertension (PH) affects 60-80% of patients with chronic heart failure (HF) and has a critical impact on prognosis. Currently, there is no specific treatment approved for this indication. Experimental research, performed by members of the consortium, demonstrates that treatment with B3 adrenergic receptor agonists produces a beneficial effect on pulmonary hemodynamics, right ventricular (RV) remodeling and pulmonary vascular proliferation in a translational pig model of postcapillary PH. Mirabegron, an oral B3AR agonist, is currently approved for a different medical condition (overactive bladder syndrome) with a good safety profile. Our main objective is to evaluate the efficacy and safety of mirabegron in patients with PH secondary to HF.
The objective will be evaluated by conducting a phase-2 randomized placebo-controlled clinical trial in patients with PH associated to HF. Patients will be randomized 1:1 to mirabegron or placebo, and dose will be titrated till 200 mg/day. Patients will be evaluated with quality of life questionnaire, blood analysis, ECG, echocardiography, 6-minute walking test, right heart catheterization (RHC) and cardiac magnetic resonance (CMR) at baseline and after 16 weeks of treatment.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Mirabegron | Active comparator | Drug: MirabegronOral mirabegron, starting with 50 mg once a day and titrated till a maximum of 200 mg once a day. |
| Placebo | Placebo comparator | Drug: PlaceboOral placebo, similarly titrated to ensure blindness. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Written inform consent;
- >18 years-old;
- HF with reduced or preserved ejection fraction, according to the definition of the European Society of Cardiology guidelines.
- Severe PH and/or combined postcapillary and precapillary PH (also knows as reactive or out-of-proportion PH) determined by RHC showing the following:
- NYHA functional class II-IV;
Key exclusion criteria (17 listed)
- Non-coronary cardiac surgery or non-coronary percutaneous procedure within the 12 months preceding recruitment or programmed;
- Myocardial infarction or coronary revascularization during the last 3 months,
- Myocardial resynchronization therapy initiated during the last 6 months;
- Sinus tachycardia or atrial fibrillation with uncontrolled heart rate (>100 bpm);
- Uncontrolled hypertension (PAS>180 or PAD>110 mmHg) or symptomatic hypotension (PAS<90 mmHg).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| MirabegronPatients will receive 50 to 200 mg of mirabegron once a day during 16 weeks. Dose will be titrated during the first 8 weeks. | Drug | Mirabegron |
| Placebo | Drug | Placebo |
Primary outcome
Change in pulmonary vascular resistance (PVR) from baseline to week 16 assessed by right heart catheterization (RHC).
Time frame: 16 weeks
14 secondary outcomes
Change from baseline in 6-minute walking distance
Time frame: 16 weeks
Change from baseline in NYHA functional class
Time frame: 16 weeks
Change from baseline in quality of life
Time frame: 16 weeks
Change from baseline in dyspnea Borg score
Time frame: 16 weeks
Change from baseline in mean PAP as assessed by RHC
Time frame: 16 weeks
Change from baseline in cardiac index (CI) as assessed by RHC and cardiac magnetic resonance (CMR)
Time frame: 16 weeks
Change from baseline in RV ejection fraction as assessed by CMR
Time frame: 16 weeks
Change from baseline in BNP/NT-proBNP
Time frame: 16 weeks
Hospital admissions due to worsening cardiopulmonary status
Time frame: 16 weeks
Mortality
Time frame: 16 weeks
Urgent heart transplantation
Time frame: 16 weeks
New onset arrhythmia
Time frame: 16 weeks
Need for initiation of intravenous therapy due to worsening HF
Time frame: 16 weeks
Adverse drug effects
Time frame: 16 weeks
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 May 2016.
- Derived from this study: PubMed 32368692Garcia-Lunar I, Blanco I, Fernandez-Friera L, Prat-Gonzalez S, Jorda P, Sanchez J, Pereda D, Pujadas S, Rivas M, Sole-Gonzalez E, Vazquez J, Blazquez Z, Garcia-Picart J, Caravaca P, Escalera N, Garcia-Pavia P, Delgado J, Segovia-Cubero J, Fuster V, Roig E, Barbera JA, Ibanez B, Garcia-Alvarez A. Design of the beta3-Adrenergic Agonist Treatment in Chronic Pulmonary Hypertension Secondary to Heart Failure Trial. JACC Basic Transl Sci. 2020 Mar 11;5(4):317-327. doi: 10.1016/j.jacbts.2020.01.009. eCollection 2020 Apr.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Mirabegron in people with Pulmonary Hypertension and Mirabegron, run by Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 11 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 17 May 2016. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Ana García-Álvarez, MD, PhD (003491 4531200 ext. 1507, anagarci@clinic.ub.es), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in pulmonary vascular resistance (PVR) from baseline to week 16 assessed by right heart catheterization (RHC). (time frame: 16 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02775539, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 May 2016.