Atrial Fibrillation or Flutter
Conditions
Brief summary
LGN-VN-003 is a prospective, multi-center, randomized, double-blind, placebo-controlled study to evaluate the safety and efficacy of a single oral dose of vanoxerine for the conversion of subjects with recent onset atrial fibrillation (AF) or atrial flutter (AFL) to normal sinus rhythm. Up to 625 subjects will be randomized in a 2:1 fashion so at least 400 vanoxerine and 200 placebo subjects receive study drug.
Interventions
DRUGVanoxerine HCl
DRUGPlacebo
Sponsors
Laguna Pharmaceuticals, Inc.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Subject has been informed of the investigational nature of this study and has given written informed consent in accordance with institutional, local, and national guidelines. * Able to return for Day 8 follow up. * Male or female 18 years of age or greater. * Onset of AF/AFL within the 7 calendar days preceding randomization, based on symptoms. * AF/AFL documented by ECG during the screening period. * Adherence to local clinical standards or the ACC/AHA or ESC practice guidelines for AF/AFL regarding thromboembolic event prevention and treatment.
Exclusion criteria
* Previous exposure to vanoxerine HCl. * Women of childbearing potential (neither surgically sterilized nor post-menopausal defined as cessation of menses for over one year) * Systolic blood pressure \<110 mmHg (unless documented to be usual value). * Average heart rate \<60 bpm documented by screening ECG. * Average QTc \>440 msec documented by screening ECG. * QRS interval \>140 msec documented by screening ECG. * Paced atrial rhythm on screening ECG. * History of receiving another Class I or Class III antiarrhythmic drug within 3 days prior to randomization. Excluded Class I antiarrhythmic drugs include quinidine, procainamide, disopyramide, lignocaine, mexilitine, flecainide, and propafenone. Excluded Class III drugs include dofetilide, sotalol, dronedarone, and ranolazine. * History of amiodarone (oral or IV) within the 90 days prior to randomization. * Native or prosthetic aortic or mitral stenosis with aortic valve area ≤1.0 cm2 or mitral valve area of \<1.5 cm2 or any other valvular diseases for which surgery is indicated. * Treatment with any loop diuretic (e.g., furosemide, bumetanide, torsemide, ethacrynic acid, etc.) in the 30 days prior to randomization. * Ejection fraction of \<35% within the 3 months prior to randomization (most recent measure if more than one). * AF/AFL as a result of surgery (postoperative AF/AFL) within 30 days prior to randomization. * History of electrical cardioversion within the 7 calendar days prior to randomization. * History of any polymorphic ventricular tachycardia including torsades de pointes. * History or family history of long QT syndrome or other inherited arrhythmia syndrome. * History of ventricular tachycardia requiring drug or device therapy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Conversion to Sinus Rhythm | 24 hours | Conversion to sinus rhythm (or atrial paced rhythm in the case of subjects with a pacemaker and atrial leads) documented by ECG (Holter ECG, 12-lead ECG, monitor lead ECG, or other format ECG) of at least 1 continuous minute within the 24 hours defined by the time of study drug administration through 24 hours after the time of study drug administration. |
Secondary
| Measure | Time frame |
|---|---|
| Length of Stay (From Time of Study Drug Administration) | 8 days |
Countries
Bulgaria, Hungary, Israel, Russia, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Vanoxerine HCl Vanoxerine HCl, 400 mg (2 x 200 mg capsules), orally, single dose
Vanoxerine HCl | 26 |
| Placebo identically matching placebo capsules, orally, single-dose
Placebo | 15 |
| Total | 41 |
Baseline characteristics
| Characteristic | Vanoxerine HCl | Placebo | Total |
|---|---|---|---|
| Age, Continuous | 68.1 years STANDARD_DEVIATION 9.3 | 66.9 years STANDARD_DEVIATION 11.3 | 67.7 years STANDARD_DEVIATION 10 |
| Aortic regurgitation | 4 participants | 1 participants | 5 participants |
| Aortic stenosis | 1 participants | 0 participants | 1 participants |
| Aspirin | 5 participants | 2 participants | 7 participants |
| COPD | 2 participants | 1 participants | 3 participants |
| Diabetes mellitus | 4 participants | 0 participants | 4 participants |
| Heart failure | 5 participants | 2 participants | 7 participants |
| Hyperlipidemia | 8 participants | 6 participants | 14 participants |
| Hypertension | 16 participants | 11 participants | 27 participants |
| Hyperthyroidism | 1 participants | 0 participants | 1 participants |
| Hypothyroidism | 3 participants | 0 participants | 3 participants |
| Ischemic heart disease | 3 participants | 3 participants | 6 participants |
| LVEF, mean | 54.3 % STANDARD_DEVIATION 8.4 | 55.1 % STANDARD_DEVIATION 12.4 | 54.6 % STANDARD_DEVIATION 9.7 |
| Mitral regurgitation | 10 participants | 4 participants | 14 participants |
| Mitral stenosis | 0 participants | 0 participants | 0 participants |
| Non vitamin K antagonist | 4 participants | 2 participants | 6 participants |
| Other anticoagulant | 11 participants | 3 participants | 14 participants |
| Pacemaker | 1 participants | 0 participants | 1 participants |
| Prior AF/AFL | 16 participants | 7 participants | 23 participants |
| Prior antiarrhythmic drug therapy | 0 participants | 2 participants | 2 participants |
| Prior catheter ablation of AF | 1 participants | 0 participants | 1 participants |
| Prior revascularization (PCI or CABG) | 2 participants | 2 participants | 4 participants |
| Prior stroke | 0 participants | 2 participants | 2 participants |
| Sex: Female, Male Female | 5 Participants | 7 Participants | 12 Participants |
| Sex: Female, Male Male | 21 Participants | 8 Participants | 29 Participants |
| Warfarin | 3 participants | 1 participants | 4 participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 26 | 0 / 15 |
| serious Total, serious adverse events | 4 / 26 | 0 / 15 |
Outcome results
Primary
Conversion to Sinus Rhythm
Conversion to sinus rhythm (or atrial paced rhythm in the case of subjects with a pacemaker and atrial leads) documented by ECG (Holter ECG, 12-lead ECG, monitor lead ECG, or other format ECG) of at least 1 continuous minute within the 24 hours defined by the time of study drug administration through 24 hours after the time of study drug administration.
Time frame: 24 hours
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Vanoxerine HCl | Conversion to Sinus Rhythm | 18 participants |
| Placebo | Conversion to Sinus Rhythm | 3 participants |
Secondary
Length of Stay (From Time of Study Drug Administration)
Time frame: 8 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Vanoxerine HCl | Length of Stay (From Time of Study Drug Administration) | 4.7 days | Standard Deviation 3.2 |
| Placebo | Length of Stay (From Time of Study Drug Administration) | 4.2 days | Standard Deviation 2.9 |