The chymase inhibitor Fulacimstat is developed as a first-in-class treatment option for the inhibition of adverse cardiac remodeling in patients with left ventricular dysfunction ( LVD ) after acute myocardial infarction.
The aim of the study CHIARA MIA 1 was to examine the safety and tolerability of Fulacimstat in patients with left ventricular dysfunction after remote myocardial infarction.
A multicenter, multinational randomized, placebo-controlled study was performed in clinically stable patients ( 40-79 years of age, left ventricular ejection fraction less than or equal to 45% because of myocardial infarction in medical history ) who were on stable evidence-based standard-of-care therapies for left ventricular dysfunction post-myocardial infarction including an angiotensin converting enzyme inhibitor or angiotensin receptor blocker at doses of at least half the recommended target dose.
Patients were treated for 2 weeks with either placebo ( n = 12 ) or 4 different doses of Fulacimstat ( 5 mg twice daily, n = 9; 10 mg twice daily, n = 9; 25 mg twice daily, n = 10; 50 mg once daily, n = 9 ).
Fulacimstat was safe and well tolerated at all examined doses. There were no clinically relevant effects on vital signs or potassium levels compared with placebo treatment.
Mean plasma concentrations of Fulacimstat increased with the administered dose and reached exposures predicted to be therapeutically active.
The safety profile and the absence of effects on blood pressure or heart rate in a chronic patient population having similar comorbidities and receiving similar comedication as patients after acute myocardial infarction support future clinical trials with Fulacimstat in patients after acute myocardial infarction.
Düngen HD et al, Clin Pharmacol Drug Dev 2018; Epub ahead of print