Evaluation of Patiromer in Heart Failure Patients (PEARL-HF)

Relypsa

Status and phase

Completed

Phase 2

Conditions

Hyperkalemia

Heart Failure

Treatments

Drug: placebo

Drug: patiromer

Study type

Interventional

Funder types

Industry

Identifiers

NCT00868439

RLY5016-202

Details and patient eligibility

About

The purpose of this study was to assess the effects of patiromer on serum potassium participants with heart failure. This study also assessed the safety and tolerability of patiromer in participants with heart failure.

Full description

This was a double-blind, randomized, placebo-controlled, parallel-group, multiple-dose study in congestive heart failure participants. Depending on the outcome from the initial cohort of 100 participants (Part 1), a second cohort of 170 participants could have been enrolled (Part 2). Based on the results of Part 1 of the study, Part 2 was not conducted.

Participants were randomly assigned to and received patiromer (30 g/day) or placebo for up to 28 days. All participants also received spironolactone; the initial spironolactone dose was 25 mg daily and was increased to 50 mg daily for participants who had a serum potassium ≤ 5.1 mEq/L on treatment Day 14. Study visits occurred on treatment Days 3, 7, 14, 17, 21 and 28. A safety follow-up contact was made 7 days after administration of last dose of study drug.

Enrollment

120 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Participants with chronic heart failure clinically indicated to receive spironolactone therapy, aged 18 years or older with serum potassium level of 4.3 - 5.1 mEq/L at screening and baseline, AND (1) chronic kidney disease (GFR < 60 mL/min) OR (2) documented history of hyperkalemia within the last 6 months
Females of child-bearing potential must be non-lactating, must have a negative serum pregnancy test at screening, and must have used a highly effective form of contraception for at least 3 months before study drug administration, during the study, and for one month after study completion
Male participants and/or their female partners of child-bearing potential must use a highly effective form of contraception during the study and for 3 months after study completion
Must sign informed consent document

Exclusion criteria

History of bowel obstruction, swallowing disorders, severe gastrointestinal disorders or major gastrointestinal surgery
Uncorrected hemodynamically significant primary valvular disease, known obstructive or restrictive cardiomyopathy, uncontrolled or hemodynamically unstable arrhythmia
Coronary-artery bypass graft, percutaneous intervention (e.g. cardiac, cerebrovascular, aortic), or major surgery including thoracic and cardiac, within 3 months prior to baseline or anticipated need during study participation
Heart transplant recipient, or anticipated need for transplant during study participation
Any of the following events having occurred within 3 months prior to baseline: unstable angina as judged by the Investigator, unresolved acute coronary syndrome, transient ischemic attack or stroke
Current dialysis participant, or anticipated need for dialysis during study participation
Prior kidney transplant, or anticipated need for transplant during study participation
Metastatic, late-stage or end-stage cancer with < 12 months life expectancy
History of alcoholism or drug/chemical abuse within 1 year
QTcB interval > 500 msec (Bazett's correction formula)
Sustained systolic blood pressure > 170 or < 90 mmHg
Liver enzymes (ALT, AST) > 3 times upper limit of normal
Use of oral cardiac medications (including loop and thiazide diuretics) that have not been stable for at least 21 days prior to baseline and are not anticipated to remain stable during study participation
Use of any IV cardiac medications within 21 days prior to baseline, or their anticipated need during study participation.
Current use of polymer-based drugs (e.g. Renagel, Kayexalate, Welchol, Colestid), other phosphate binders or potassium binders, calcium supplements, antacids (eg TUMS, Maalox), or their anticipated need during study participation
Use of aldosterone antagonist in the last 30 days prior to baseline, unless was discontinued due to hyperkalemia
Use of potassium sparing medication and/or potassium supplements in the last 30 days prior to baseline
Use of any investigational medication, 30 days or 5 half-lives whichever is longer, prior to baseline
Participants who have taken investigational product in this study, or a previous patiromer study
Inability to consume the study medication, or, in the opinion of the Investigator, inability to comply with the protocol
In the opinion of the Investigator, any medical condition, uncontrolled systemic disease, serious intercurrent illness, or extenuating circumstance occurring or persisting, within 30 days prior to baseline, that would significantly decrease study compliance or jeopardize the safety of the participant or affect the validity of the trial results