Study Assessing Left Ventricular Administration of a Genetic Medicine Directing Organ Regeneration in Heart Failure

Launched by YAP THERAPEUTICS, INC. · Feb 12, 2025

Keywords

ClinConnect Summary

This clinical trial is studying a new gene therapy called YAP101, aimed at helping people with heart failure caused by previous heart attacks. Heart failure means that the heart is not pumping blood as well as it should, which can lead to symptoms like fatigue and difficulty with daily activities. YAP101 is designed to improve heart function by encouraging the heart muscles to heal and regenerate, potentially leading to better overall heart health.

To participate in this trial, individuals must be between 18 and 80 years old and have specific heart conditions, including stable heart failure with reduced heart function that hasn't improved in the last year. Participants will receive a one-time injection of YAP101 in a minimally invasive procedure and will be monitored for a year to check for any side effects and to see if their heart function, exercise ability, and quality of life improve. It’s important to note that not everyone will qualify, as there are certain health conditions that could exclude someone from participating. If you're interested in learning more or think you might be eligible, please talk to your doctor.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• To participate, a subject MUST:
• • 1. Be ≥ 18 and \< 80 years of age;
• • 2. Have medically stable heart failure of ischemic etiology, secondary to MI with NYHA class II or III symptoms for at least 12 months before the initiation of screening procedures;
• • 3. Have a left ventricular ejection fraction (LVEF) ≥ 20% and ≤ 40% by cMRI at screening and baseline;
• • 4. The subject is not a candidate for either percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery as determined by the principal investigator (or designee) in consultation with an interventional cardiologist during the screening period;
• • 5. Be on stable, outpatient, maximally tolerated guideline directed medical therapy (GDMT) for HF for 6 weeks, unless contraindicated, and remain stable during the screening period;
• • 6. Left ventricular (LV) end diastolic wall thickness of at least 8mm at the potential myocardial site for injection;
• • 7. Be a candidate for cardiac catheterization;
• • 8. Agree to protocol defined requirements for contraception;
• • 9. Provide written informed consent.
• Exclusion Criteria:
• To participate, a subject MUST NOT HAVE:
• • 1. Valvular heart disease including 1) mechanical or bioprosthetic heart valve; or 2) severe valvular (any valve) insufficiency/regurgitation within 12 months of consent;
• • 2. Aortic stenosis with valve area ≤ 1.5cm2;
• • 3. Prior heart transplant, history of LV reduction surgery, cardiomyoplasty, passive restraint device
• • 4. Had an acute myocardial infarction within the prior 30 days before initiation of screening;
• • 5. Unstable angina pectoris within 30 days before initiation of screening procedures;
• • 6. Idiopathic, valvular, peri/post-partum cardiomyopathy or other cardiomyopathy of non-ischemic etiology;
• • 7. Restrictive, obstructive, or infiltrative cardiomyopathy; pericardial constriction; amyloidosis; or uncorrected thyroid disease;
• • 8. A history of ischemic or hemorrhagic stroke within 90 days of screening;
• • 9. Liver dysfunction, as evidenced by enzymes (e.g., AST, ALT, alkaline phosphatase) greater than 3 times upper limit of normal;
• • 10. A baseline eGFR \<35 mL/min/1.73m2;
• • 11. Diabetes with poorly controlled blood glucose levels (HbA1c \> 10%);
• • 12. A hematologic abnormality during baseline testing;
• • 13. Coagulopathy (INR \> 1.5) not due to a reversible cause (e.g., warfarin and/or Factor Xa inhibitors); Subjects who cannot be withdrawn from anticoagulation will be excluded;
• • 14. An underlying autoimmune disorder or current immunosuppressive therapy;
• • 15. A contrast allergy that cannot adequately be managed by premedication;
• • 16. Received cell-based therapy from any source;
• • 17. Received any viral vector mediated gene therapy;
• • 18. Evidence of active systemic infection at time of study product delivery;
• • 19. HIV and/or active HBV, HCV or Covid-19 infection at screening or baseline;
• • 20. Presence of LV thrombus;
• 21. Presence of a pacemaker or ICD generator with any of the following limitations/conditions:
• • 1. manufactured before the year 2000
• • 2. leads implanted \< 6 weeks prior to screening
• • 3. non-transvenous epicardial leads
• • 4. subcutaneous ICDs
• • 5. any other condition that, in the judgment of device-trained staff, would deem an MRI contraindicated;
• • 22. A cardiac resynchronization therapy (CRT) device implanted \< 3 months prior to consent;
• • 23. Other MRI contraindications
• • 24. Mobitz II or higher degree atrioventricular block without a functioning pacemaker within 3 months of consent;
• • 25. A history of drug abuse or alcohol abuse, or documented medical, occupational, or legal problems arising from the use of alcohol or drugs within the past 24 months;
• • 26. Cognitive or language barriers that prohibit obtaining informed consent or any study elements;
• • 27. Participation (currently or within the previous 30 days) in a cardiac related investigational therapeutic (including stem cell and gene-based therapies) or device trial;
• • 28. Pregnancy, lactation, plans to become pregnant in the next 12 months, or is unwilling to use acceptable forms of birth control during study participation;
• • 29. Expected survival \< 1 year in the judgment of the investigator;
• • 30. Active malignancy within the past 3 years (exceptions: localized prostate cancer, cervical or breast cancer in situ, or nonmelanoma skin cancer that has been definitively treated);