Mechano-energetic uncoupling in heart failure.
Dunja Aksentijevic, Simon Sedej, Jeremy Fauconnier...
https://pubmed.ncbi.nlm.nih.gov/40544170/Actively Recruiting
Led by Cytokinetics · Updated on 2026-07-29
1800
Participants Needed
199
Research Sites
13 weeks
Total Duration
Researchers are evaluating the investigational drug omecamtiv mecarbil to see if it can lower the risk of serious effects related to heart failure, such as hospitalization, heart transplantation, or death, in patients with symptomatic heart failure and severely reduced ejection fraction. This phase 3 trial aims to assess both the effectiveness and safety of the drug compared to placebo in reducing cardiovascular events including death, heart failure events, left ventricular assist device implantation, cardiac transplantation, and stroke. Participants will be randomly assigned to receive either omecamtiv mecarbil or a placebo. Those in the omecamtiv mecarbil group will take an oral tablet twice daily at a dose based on their blood drug levels 25, 37.5, or 50 mg. The placebo group will receive matching tablets twice daily. The study will continue until at least 850 participants experience a heart failure event or cardiovascular death. An interim analysis will be performed when about 67% of these events have occurred. The total estimated participation duration is up to 3 years. During the trial, participants will be regularly monitored for cardiovascular events, hospitalizations, and other health outcomes. Researchers will measure the time to first cardiovascular death or heart failure event among other secondary outcomes such as stroke and overall survival. Safety will be carefully tracked throughout the study. Participants adherence to the study medication and health status will be assessed at scheduled visits over the course of the study.
CONDITIONS
Study With Omecamtiv Mecarbil (CK-1827452) to Treat Chronic Heart Failure With Severely Reduced Ejection Fraction
C
Cytokinetics MD
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Cytokinetics
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Omecamtiv Mecarbil + GDMT | Placebo + GDMT | Standard GDMT (external) |
|---|---|---|---|
| What it is | An oral cardiac myosin activator added to guideline‑directed therapy in patients with chronic HFrEF | A matching oral placebo added to guideline‑directed therapy | Current therapy for HFrEF is guideline‑directed medical therapy without investigational myosin activation |
| Role in trial | Investigational arm evaluated against placebo | Placebo control added to standard care | Represents usual guideline‑directed care outside the trial context |
| Primary use | Test whether omecamtiv mecarbil reduces risk of heart failure events or cardiovascular death on top of GDMT | Provide control comparison to assess investigational benefit | Baseline current clinical management without additional investigational treatment |
| How it is given or performed | Oral tablet given twice daily with pharmacokinetic‑guided dosing | Matching oral placebo administered similarly | Standard oral medications per guideline without investigational tablets |
| Evidence status | Phase 3 data (GALACTIC‑HF) show modest reduction (~8%) in composite of CV death or HF events when added to GDMT (hazard ratio ~0.92) | Standard placebo comparator arm achieved baseline event rates used to assess investigational effect | GDMT is established to reduce morbidity and mortality in HFrEF based on robust evidence |
| Important risks | Higher plasma concentrations may be associated with ischemic events; overall safety similar to placebo in trial | No investigational drug; placebo safety profile mirrors background care | Established medications have known safety profiles and are routinely monitored |
| Important limitations | Benefit is modest and driven by HF hospitalizations; no significant reduction in cardiovascular death alone | Placebo arm does not reflect benefit beyond standard care, limiting interpretability of absolute effect outside trial | No trial data directly compare GDMT alone versus OM added in community settings; external comparison is indirect |
| Patient impact | Reduced risk of heart failure hospitalization or cardiovascular death by approximately 8% when added to GDMT | Serves as reference for usual risks on top of standard therapy | Known to improve survival and reduce hospitalizations as established long‑term therapy |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Up to 3 years
Participants take either omecamtiv mecarbil or placebo tablets twice daily. Dosing for omecamtiv mecarbil depends on blood drug levels. Treatment continues until enough participants experience a heart failure event or cardiovascular death.
Regular visits throughout the study
Duration - Up to 3 years
Participants are monitored for cardiovascular events, hospitalizations, and overall health until the last participant completes the study.
Visits at regular intervals during treatment and follow-up
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Dunja Aksentijevic, Simon Sedej, Jeremy Fauconnier...
https://pubmed.ncbi.nlm.nih.gov/40544170/Cytokinetics
Lead Sponsor