NCT04405804

Early Administration of Ivabradine in Children With Heart Failure

A Monocentric, Open Label, Single Arm, Pilot Study on the Early Administration of Ivabradine in Children Aged >6 Months and <18 Years With Dilated Cardiomyopathy and Acute Heart Failure

• Status: Unknown
• Phase: Phase 2
• Study type: Interventional
• Enrollment: 9 (estimated)
• Sponsor: Bambino Gesù Hospital and Research Institute · Academic / Other
• Sex: All
• Age: 6 Months – 17 Years
• Healthy volunteers: Not accepted

Summary

This is a monocentric, prospective, single arm, not for profit study. It is designed to study the early use of ivabradine in patients with dilated cardiomyopathy and Ejection Fraction (EF) \< 45%.

Detailed description

The study is divided into a screening and enrollment visit (V1) where eligibility for treatment will be confirmed. Ivabradine will be administered to eligible patients with increasing dosage during the titration period (TP) which will last from a minimum of 3 days to a maximum of 15 days. This will be followed by a maintenance period (MP) of the drug for a further 14 days. The follow-up period (FU) will last 4 months. The dose of ACE inhibitors will be introduced after 72 hours of clinical stability after the introduction of titrated ivabradine at maximum dose according to protocol. The anti-aldosterone will be introduced 24 hours after the introduction of ivabradine. The diuretic will not be modified during the titration phase of the drug, unless there is clinical necessity. During the FU ivabradine will be continued at stable dosage, in order to maintain the target heart rate (HR) reached during the maintenance phase (HR \> 80 bpm, in the group of patients older than 6-12 months, or HR \> 70 bpm in patients aged 1-3 years or HR \> 50 bpm between 3-18 years). In all patients, the drug dose will be decreased or discontinued in case of bradycardia (HR\< 80 bpm in patients 6-12 months, HR\< 70 bpm in patients 1-3 years of age or HR\< 60 bpm in patients 3-18 years of age) and/or symptoms related to bradycardia or for other safety reasons.

Conditions

• Acute Heart Failure
• Dilated Cardiomyopathy

Interventions

Type	Name	Description
DRUG	Ivabradine 5Mg Tab	Initial dose of ivabradine will be: 0.02 mg/kg/dose twice daily in patients between 6-12 months 0.05 mg/kg/dose twice daily in patients between 1-3 years and 3-18 years with a weight \< 40 kg 2.5 mg/day in patients between 3-18 years with weight \> 40 kg During titration phase, the dose may be increased, maintained, reduced or discontinued in accordance with titration rules. The titration rules will be adjusted on the basis of age subset and of each patient's evaluation during the titration phase, whether or not the target heart rate is reached (HR ≥ 20% compared to baseline HR) and whether or not are present bradycardia (HR should be greater than predefined by a HR threshold per age subset) and/or bradycardia-related symptoms. Maximum dose to be reached will be: 0.2 mg/kg/dose twice daily in patients between 6-12 months 0.3 mg/kg/dose twice daily in patients between 1-3 years and 3-18 years with a weight \< 40 kg 15 mg/day in patients between 3-18 years, weight \> 40 kg

Timeline

• Start date: 2020-06-20
• Primary completion: 2021-01-01
• Completion: 2021-05-01
• First posted: 2020-05-28
• Last updated: 2020-12-08

Locations

1 site across 1 country: Italy