NCT04508998

Brief Summary

Microvascular angina (MVA) is caused by abnormalities of the small blood vessels in the heart. Endothelin-1 (ET-1) is a chemical messenger that circulates and accumulates in the blood vessel walls, causing them to narrow or go into spasm and thicken over a long period, especially as levels of ET-1 increase. As a result, patients experience pain, psychological distress and limitation of their daily activities. Cambridge is a participating recruitment site for a large randomised, double blinded, placebo controlled crossover trial (the PRIZE study: NCT04097314) investigating Zibotentan as a new drug treatment for patients with MVA using a 'precision medicine' approach. Zibotentan is a drug originally developed by Astra Zeneca for prostate cancer but prior research has shown that it acts to relax the small blood vessels of patients with MVA, highlighting its potential as a novel therapy for this patient group. The PRIZE study population will be enriched for 'responders' to the drug by screening patients with MVA for a gene mutation known to increase levels of circulating endothelin. The trial aims to initially invite approximately 356 participants for genetic testing but only 100 participants will go forward into the main study, with approximately 2/3rd being screen failures. In our sub-study, we will invite patients with MVA who are screen failures at our site for further blood tests looking for other genetic variants in the ET-1 signalling pathway and examine how this correlates with the severity of microvascular angina quantified by cardiac MRI and clinical assessments. Data from this sub-study would provide a bio-resource for further analysis of the main PRIZE trial to identify other patients that would benefit from Zibotentan.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
26

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started May 2021

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

June 21, 2020

Completed
2 months until next milestone

First Posted

Study publicly available on registry

August 11, 2020

Completed
9 months until next milestone

Study Start

First participant enrolled

May 14, 2021

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 13, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 13, 2022

Completed
Last Updated

April 4, 2023

Status Verified

April 1, 2023

Enrollment Period

1.2 years

First QC Date

June 21, 2020

Last Update Submit

April 1, 2023

Conditions

Keywords

anginaendothelin receptor antagonistzibotentan

Outcome Measures

Primary Outcomes (1)

  • Correlation of ET-A SNPs with ET-A expression in blood by qPCR, levels of endothelin related plasma peptides and clinical data (exercise duration and microvascular disease measured by quantitative perfusion on Cardiac MRI)

    Measurement of molecules associated with the endothelin signalling pathway in patients with different SNPs for the ET-A receptor will be compared with phenotypic characteristics of the patients, specifically exercise tolerance and by retrospective analysis of the patient's cardiac MRI using quantitative measures of myocardial blood flow.

    correlation will be assessed at baseline at the start of the trial (time point 0)

Study Arms (1)

Patients with microvascular angina

EXPERIMENTAL

Patients with clinical features of microvascular angina screened for the main PRIZE trial however not possessing the PHACTR1 GG minor allele single nucleotide polymorphism

Diagnostic Test: Blood tests including genotypingDiagnostic Test: Exercise Tolerance Test

Interventions

Blood tests for alternative SNPs altering levels of ET-A receptor expression; blood will be further analysed for endothelin receptor mRNA and other plasma peptides important in the endothelin signalling pathway

Patients with microvascular angina

Treadmill exercise test using the Bruce protocol

Patients with microvascular angina

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age \>18 years.
  • Probable or definite Microvascular Angina as defined in COVADIS criteria:
  • Clinical symptoms of angina
  • No obstructive coronary artery disease
  • Objective evidence of myocardial ischemia
  • Evidence of impaired coronary microvascular function (Optional)
  • Able to comply with study procedures.
  • Screen failure for the main PRIZE study
  • Written informed consent.

You may not qualify if:

  • \. Lack of informed consent for the PRIZE ET Sub-study

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Royal Papworth Hospital NHS Foundation Trust

Cambridge, CB2 0AY, United Kingdom

Location

Related Publications (1)

  • Abraham GR, Morrow AJ, Oliveira J, Weir-McCall JR, Davenport EE, Berry C, Davenport AP, Hoole SP. Mechanistic study of the effect of Endothelin SNPs in microvascular angina - Protocol of the PRIZE Endothelin Sub-Study. Int J Cardiol Heart Vasc. 2022 Feb 25;39:100980. doi: 10.1016/j.ijcha.2022.100980. eCollection 2022 Apr.

    PMID: 35242999BACKGROUND

Related Links

MeSH Terms

Conditions

Microvascular AnginaAngina Pectoris

Interventions

Exercise Test

Condition Hierarchy (Ancestors)

Myocardial IschemiaHeart DiseasesCardiovascular DiseasesVascular DiseasesChest PainPainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Heart Function TestsDiagnostic Techniques, CardiovascularDiagnostic Techniques and ProceduresDiagnosisRespiratory Function TestsDiagnostic Techniques, Respiratory SystemErgometryInvestigative Techniques

Study Officials

  • Stephen Hoole

    Royal Papworth NHS Foundation Trust

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
BASIC SCIENCE
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER GOV
Responsible Party
SPONSOR

Study Record Dates

First Submitted

June 21, 2020

First Posted

August 11, 2020

Study Start

May 14, 2021

Primary Completion

August 13, 2022

Study Completion

August 13, 2022

Last Updated

April 4, 2023

Record last verified: 2023-04

Data Sharing

IPD Sharing
Will share

Data will be entered on electronic clinical record forms inputed on the Open Clinica eCRF platform with password protected access for researchers and for quality assurance personnel only.

Shared Documents
STUDY PROTOCOL, ICF, CSR
Time Frame
A combined analysis with other leftover patient samples from other PRIZE trial participating sites is in progress. It is anticipated the clinical study report will be available in February 2024
Access Criteria
Individual participant data will not be shared routinely in this or any related research.

Locations