Study Description
This Phase 2a clinical trial will evaluate the effectiveness, safety, and tolerability of
increasing dose strengths of an oral daily medication, DFV890, administered for 12 weeks,
or a single s.c. dose of MAS825, to reduce key markers of inflammation related to CVD
risk, such as IL-6 and IL-18, in approximately 28 people with known coronary heart
disease and TET2 or DNMT3A CHIP (VAF ≥2%). This is a multi-center, randomized, placebo-controlled, participant- and
investigator-blinded study.
The study consists of a screening period up to 30 days; a treatment period of
approximately 12 weeks with an end of treatment (EOT) visit on Day 85, which is one day
after the last dose of DFV890 or placebo; a follow-up period of approximately 1 week; and
a standard safety follow-up call approximately 30 days following the last dose. The
overall study duration is approximately 21 weeks.
Participants will be randomized to one of five treatment sequences. Based on the
treatment sequence assignments, participants will start on either a combination of MAS825
and placebo, DFV890 and placebo, or placebo and placebo on Day 1, and then, within each
DFV890 treatment sequence, participants will receive up-titrating doses of DFV890 or
placebo at the corresponding study visits.
Interventions
DFV890
DFV890 placebo
MAS825
MAS825 Placebo
Eligibility Criteria
Inclusion Criteria:
- Male and female participants aged between 18 - 80 years (inclusive) at the start of
screening will be included.
- Participants must have a body mass index (BMI) within the range of 18 - 40 kg/m2 at
screening. BMI = Body weight (kg) / [Height (m)]2.
- Documented spontaneous myocardial infarction (MI) (diagnosed according to the
universal MI criteria with or without evidence of ST segment elevation) at least 30
days before the start of screening (Thygesen et al 2007).
- Known presence of CHIP, restricted to driver mutations in TET2 or DNMT3A with a VAF
≥2%, as documented in the participant's medical history.
- For participants on statin therapy (HMG-CoA reductase inhibitor) as clinically
indicated, participants must be on a stable regimen (at least 4 weeks before
randomization), with no planned statin dose changes over the course of the trial
treatment period. Unplanned statin dose changes during the trial treatment period
may occur.
Exclusion Criteria:
- Patients receiving concomitant medications that are known to be strong or moderate
inducers of cytochrome CYP2C9 enzyme and/or strong inducers of CYP3A, strong
inhibitors of CYP2C9 and/or strong or moderate inhibitors of CYP3A and the treatment
cannot be discontinued or switched to a different medication within 5 half-lives or
1 week (whichever is longer) prior to Day 1 and for the duration of the study.
- At screening, pre-malignant clonal cytopenias or clonal cytopenia of unknown
significance (CCUS).
- History of ongoing, chronic, or major recurrent infectious disease, at the
discretion of the Investigator, at the start of screening.
- Patients with suspected or proven immunocompromised state at screening.
- Use of any biologic drugs targeting the immune system within 26 weeks of Day 1.
- Multi-vessel coronary artery bypass graft (CABG) surgery within the past 3 years
prior to the start of screening.
- Planned coronary revascularization (percutaneous coronary intervention (PCI) or
CABG) or any other major surgical procedure during the study (until End of Study
(EOS)).
- Symptomatic Class IV heart failure (New York Heart Association [NYHA]) at the start
of screening.
Other protocol-defined inclusion/exclusion criteria may apply
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