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Ranolazine

Phase 3

Type 2 Diabetes Mellitus | Small molecule | Metabolic |Gilead Sciences, Inc.|Last Updated: Apr 7, 2022

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindACTIVE_CONTROLLEDDMC
Total Trials6
Total Enrollment1,411

FDA Designations

No designations recorded

Clinical trial landscape

Ranolazine · 16 trials · 14 indications

Phase 3 7Phase 2 5Phase 1 4
NCT01174173Ranolazine and Pulmonary HypertensionAngina
COMPLETED11 Analytics
NCT01555164A Phase 3 Study of Ranolazine in Subjects With Type 2 Diabetes Who Are Inadequately Controlled on Metformin AloneType 2 Diabetes Mellitus
COMPLETED442 Analytics
NCT01494987Ranolazine When Added to Glimepiride in Subjects With Type 2 Diabetes MellitusType 2 Diabetes Mellitus
COMPLETED431 Analytics
NCT01472185Ranolazine Monotherapy in Subjects With Type 2 Diabetes MellitusType 2 Diabetes Mellitus
COMPLETED465 Analytics
NCT01442038Ranolazine for Incomplete Vessel Revascularization Post-Percutaneous Coronary Intervention (PCI)Coronary Artery Disease
COMPLETED2,651 Analytics
NCT00099788Metabolic Efficiency With Ranolazine for Less Ischemia in Non-ST Elevation Acute Coronary SyndromesMyocardial Ischemia
COMPLETED6,560 Analytics
NCT00091429Ranolazine SR in Patients With Chronic Angina Who Remain Symptomatic Despite Maximal Treatment With AmlodipineAngina
COMPLETED500 Analytics
PHASE3COMPLETED
Ranolazine and Pulmonary Hypertension
AnginaUnlock trial analytics
PHASE3COMPLETED
A Phase 3 Study of Ranolazine in Subjects With Type 2 Diabetes Who Are Inadequately Controlled on Metformin Alone
Type 2 Diabetes MellitusUnlock trial analytics
PHASE3COMPLETED
Ranolazine When Added to Glimepiride in Subjects With Type 2 Diabetes Mellitus
Type 2 Diabetes MellitusUnlock trial analytics
PHASE3COMPLETED
Ranolazine Monotherapy in Subjects With Type 2 Diabetes Mellitus
Type 2 Diabetes MellitusUnlock trial analytics
PHASE3COMPLETED
Ranolazine for Incomplete Vessel Revascularization Post-Percutaneous Coronary Intervention (PCI)
Coronary Artery DiseaseUnlock trial analytics
PHASE3COMPLETED
Metabolic Efficiency With Ranolazine for Less Ischemia in Non-ST Elevation Acute Coronary Syndromes
Myocardial IschemiaUnlock trial analytics
PHASE3COMPLETED
Ranolazine SR in Patients With Chronic Angina Who Remain Symptomatic Despite Maximal Treatment With Amlodipine
AnginaUnlock trial analytics

Study Endpoints

Primary Endpoints

Improve Angina Symptoms
3 months

Assessed as average improvement in WHO Functional Class. The WHO Functional Class score ranges from 1 to 4, with higher scores indicating more impairment

6-Minute Walk Test
3 Months

Improve Exercise Capacity measured by 6-Minute Walk Test

Improve Quality of Life
3 Months

The Kansas City Cardiomyopathy Questionnaire is a 23-item, self-administered instrument that quantifies physical function, symptoms (frequency, severity and recent change), social function, self-efficacy and knowledge, and quality of life. The scores are averaged and transformed to a range of 0-100, in which higher scores reflect better health status and was performed at the conclusion of the study.

Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 24
Baseline; Week 24

The average (mean) change from baseline in HbA1c at Week 24 was analyzed.

Kaplan-Meier Estimates for Time From Randomization to First Occurrence of Ischemia-driven Revascularization or Ischemia-driven Hospitalization Without Revascularization
Baseline through end of study (average 90 weeks)

Time to event distributions were estimated by the Kaplan-Meier (KM) method. 1 month = 28 days; 1 calendar year = 365 days.

Time to first occurrence of any element of the composite of cardiovascular death, myocardial infarction or recurrent ischemia through the end of the follow-up in non-ST elevation ACS.
First occurrence
Change in Seattle Angina Questionnaire Score Regarding Angina Frequency
Baseline, Week 12

The change in scores of the angina frequency dimension of the Seattle Angina Questionnaire (SAQ) after 12 weeks therapy with ranolazine or placebo are presented. Change at 12 weeks was calculated as (Endpoint Value at 12 weeks - Endpoint Value at Baseline)/Endpoint Value at Baseline. Individual dimensions of the Seattle Angina Questionnaire are transformed to be a score from 0 to 100, where higher scores indicate better health. A positive number for the angina frequency dimension means that the participants are experiencing fewer episodes of angina at week 12 than they were at the baseline visit.

Change in QTc Duration at 2 Months
1 month to 2 months

Change in QTc at 2 months on ranolazine vs. at 1 month on placebo. This was prespecified outcome.

Atrial Fibrillation Burden (AFB) at Baseline
Baseline

AFB was defined as the total time a participant was in atrial tachycardia (AT)/atrial fibrillation (AF) expressed as a percentage of total recording time. Geometric mean is the mean of log-transformed AFB exponentiated.

Percent Change From Baseline in Atrial Fibrillation Burden (AFB) by Week 12
Baseline; Week 12

AFB was defined as the total time a participant was in atrial tachycardia (AT)/atrial fibrillation (AF) expressed as a percentage of total recording time. Data are presented for baseline-adjusted AFB over 12 weeks of treatment. Geometric mean is the mean of log-transformed AFB exponentiated.

Absolute Change From Baseline in AFB by Week 12
Baseline; Week 12

AFB is defined as the total time a participant is in AT/AF expressed as a percentage of total recording time. Data are presented for baseline-adjusted AFB over 12 weeks of treatment.

Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 12
Baseline to Week 12

HbA1c is a blood test to measure blood sugar control over the prior 3-month period. The last observation carried forward (LOCF) method was used: the last observed post-baseline measurements prior to Week 12 carried forward for participants with no available Week 12 values. Participants were summarized according to the actual treatment received regardless of the allocated treatment.

Change From Baseline in 2-hour Postprandial Serum Glucose at Week 12 Following a Standardized Meal
Baseline to Week 12

2-hour postprandial serum glucose was defined as the average of serum glucose measurement at 120 minutes and 125 minutes following a standardized meal. The LOCF method was used. Participants were summarized according to the actual treatment received regardless of the allocated treatment.

Change From Baseline in Fasting Serum Glucose at Week 12
Baseline to Week 12

Serum glucose was measured following an overnight fast. The LOCF method was used. Participants were summarized according to the actual treatment received regardless of the allocated treatment.

Change from baseline to 30 minutes in cardiac catheterization hemodynamic parameters at both resting and paced conditions
Baseline to 30 minutes

Change from baseline to 30 minutes from initiation of study drug bolus No.1 in cardiac catheterization hemodynamic parameters at both resting and paced conditions: Time-constant of relaxation (tau) Left ventricular end-diastolic pressure (LVEDP) dP/dtmin (minimal rate of LV pressure change)

Questionnaires: Short Form Health Survey (SF-36) and Individualized Neuromuscular Quality of Life Questionnaire (INQoL)
1 month

quality of life measurements for overall health and neuromuscular disease

Muscle tasks
1 month

The subject is observed and timed while rising from an arm chair, walking 3 meters, turning, walking back, and sitting down again

Electromyography (EMG) Myotonia
1 month

To see if the electrical potentials produced by the muscle fibers change.

Area under the concentration-time curve (AUC) of plasma glucagon during the standard meal test (SMT)
Days 5, 10, and 14
Maximum observed plasma concentration (Cmax) of metformin
0, 0.5, 1,1.5, 2, 3, 4, 6, 8, 10 and 12 hours post-dose on Days 5 and 10
Area under the plasma concentration vs time curve over the dosing interval, at steady state (AUCtau) of metformin
0, 0.5, 1,1.5, 2, 3, 4, 6, 8, 10 and 12 hours post-dose on Days 5 and 10
Time to reach maximum observed plasma concentration (Cmax) of metformin
0, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10 and 12 hours post-dose on Days 5, 10, 15 and 20
Area under the plasma concentration versus time curve over the dosing interval, at steady state (AUCtau) of metformin
0, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10 and 12 hours post-dose on Days 5, 10, 15 and 20

Secondary Endpoints

RV Perfusion on Cardiac MRI
3 months
Absolute RV Longitudinal Strain
3 months
Right Ventricular Hemodynamics
3 months
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
RanolazineEXPERIMENTAL1000 mg PO BID
Ranolazine+metforminEXPERIMENTALQualifying Period: Participants will receive metformin 1000 mg + placebo to match ranolazine twice daily for either 2 or 8 weeks (dependent on metformin dose and HbA1c level at Screening). Treatment Period: Participants will receive ranolazine 500 mg + metformin 500 mg + placebo to match metformin twice daily on Days 1 through 7, followed by ranolazine 1000 mg + metformin 500 mg + placebo to match metformin twice daily from Day 8 through Week 24. Participants are required to maintain their diet and exercise regimen.
Placebo+metforminPLACEBO_COMPARATORQualifying Period: Participants will receive metformin 1000 mg + placebo to match ranolazine twice daily for either 2 or 8 weeks (dependent on metformin dose and HbA1c level at Screening). Treatment Period: Participants will receive metformin 1000 mg + placebo to match ranolazine twice daily through Week 24. Participants are required to maintain their diet and exercise regimen.
Ranolazine+glimepirideEXPERIMENTALGlimepiride stabilization period (up to 8 weeks): participants not on stable glimepiride will receive glimepiride 2 mg once daily, and if tolerated the dose will be increased on Day 8 (+ 2 days) to 4 mg once daily. Qualifying period: participants will receive placebo to match ranolazine twice daily in addition to glimepiride for 14 days (+ 2 days) and if ≥ 80% compliant and meeting eligibility criteria will continue to the treatment period. Treatment period: participants will be randomized to receive ranolazine 500 mg twice daily plus glimepiride 4 mg once daily on Days 1 through 7, followed by ranolazine 1000 mg twice daily plus glimepiride 4 mg once daily from Day 8 (or by Day 16 if not well tolerated) through Week 24. Participants will be required to maintain their diet and exercise regimen.
Placebo+glimepiridePLACEBO_COMPARATORGlimepiride stabilization period (up to 8 weeks): participants not on stable glimepiride will receive glimepiride 2 mg once daily, and if tolerated the dose will be increased on Day 8 (+ 2 days) to 4 mg once daily. Qualifying period: participants will receive placebo to match ranolazine twice daily in addition to glimepiride for 14 days (+ 2 days) and if ≥ 80% compliant and meeting eligibility criteria will continue to the treatment period. Treatment period: participants will be randomized to receive placebo to match ranolazine plus glimepiride 4 mg once daily for 24 weeks. Participants will be required to maintain their diet and exercise regimen.
PlaceboPLACEBO_COMPARATORQualifying Period: Placebo to match ranolazine (1 tablet twice daily) for 14 days. Treatment Period: Placebo to match ranolazine (Days 1-7: 1 tablet twice daily; 2 tablets twice daily thereafter) for up to 24 weeks. Participants were required to maintain their diet and exercise regimen.
1EXPERIMENTALRanolazine
2PLACEBO_COMPARATORPlacebo
Placebo followed by Ranolazine AdministrationEXPERIMENTALPlacebo for 1 month and Ranolazine for 5 months.
Ranolazine 750 mgEXPERIMENTALRanolazine 750 mg plus dronedarone placebo for 12 weeks.
Dronedarone 225 mgEXPERIMENTALRanolazine placebo plus dronedarone 225 mg for 12 weeks.
Ranolazine 750 mg + Dronedarone 225 mgEXPERIMENTALRanolazine 750 mg plus dronedarone 225 mg for 12 weeks.
Ranolazine 750 mg + Dronedarone 150 mgEXPERIMENTALRanolazine 750 mg plus dronedarone 150 mg for 12 weeks.
Saline 0.9%PLACEBO_COMPARATORSaline 0.9% and placebo tablet
Placebo, Ranolazine, ExenatideACTIVE_COMPARATOR -
Ranolazine, Placebo, ExenatideACTIVE_COMPARATOR -
Metformin, RanolazineEXPERIMENTALSingle cohort, 2-period study: * Period 1, metformin 1000 mg bid on Days 1-5 * Period 2, metformin 1000 mg bid + ranolazine 500 mg bid on Days 6-10

Interventions

NameTypeDescription
RanolazineDRUGranolazine 1000 mg PO BID for 3 months
Placebo to match ranolazineDRUGPlacebo to match ranolazine for the duration of the study
MetforminDRUGMetformin tablet(s) administered orally once daily
Placebo to match metforminDRUGPlacebo to match metformin for the duration of the study
DietBEHAVIORALParticipants are instructed to continue the diet regimen prescribed by their physician.
ExerciseBEHAVIORALParticipants are instructed to continue the exercise regimen prescribed by their physician.
PlaceboDRUGPlacebo to match ranolazine for the duration of the study
GlimepirideDRUGGlimepiride tablets (2 mg or 4 mg) administered orally once daily with the morning dose of study drug or placebo. The target dosing regimen for glimepiride is 4 mg once daily.
DronedaroneDRUGCapsule administered orally twice daily
Ranolazine placeboDRUGTablets administered orally twice daily.
Dronedarone placeboDRUGCapsules administered orally twice daily
Saline 0.9% and placebo tabletOTHERIntravenous treatment followed by oral treatment for 13 days
ExenatideDRUG -
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Eligibility Criteria

Age Range18 Years to 80 Years
SexALL
Healthy VolunteersNo
Study Sites1

Inclusion criteria: 1. World Health Organization (WHO) Group 1 PAH, defined as a pulmonary hypertension with mean pulmonary artery pressure \> 25 mmHg, pulmonary capillary wedge pressure \< 15 mmHg, and pulmonary vascular resistance \> 3 Wood units. 2. Right ventricular dysfunction, defined as RV f...

Countries:United StatesCanadaCzechiaHungaryIndiaIsraelMexicoPolandRussiaSouth AfricaUkraineMalaysiaRomaniaSerbiaSlovakiaThailandAustriaBelgiumFranceGermanyItalyNetherlandsSpainSwedenUnited Kingdom
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Frequently asked questions about Ranolazine

What is Ranolazine used for?

Ranolazine is a small molecule cardiovascular drug being developed by Gilead Sciences for multiple indications, including microvascular angina, myotonia congenita, atrial fibrillation, angina, coronary artery disease, and diastolic heart failure. It has been studied in Phase 3 trials for coronary artery disease and angina pectoris.

What does Ranolazine target?

Ranolazine is a small molecule that modulates cardiac sodium and potassium channels, specifically inhibiting the late sodium current. This mechanism is thought to reduce intracellular calcium overload during ischemia, which may improve myocardial relaxation and reduce angina symptoms.

Who makes Ranolazine?

Ranolazine is developed by Gilead Sciences, Inc., a biopharmaceutical company traded on NASDAQ under the ticker GILD. The company has sponsored multiple clinical trials evaluating the drug across cardiovascular and neuromuscular conditions.

What phase is Ranolazine in?

Ranolazine has completed Phase 3 clinical trials for coronary artery disease and angina pectoris, with a large study of 2,651 patients. It has also completed Phase 2 trials for diastolic heart failure and atrial fibrillation, and a Phase 1 trial for myotonia congenita.

What clinical trials is Ranolazine in?

Ranolazine has been studied in six completed clinical trials. Key trials include NCT01442038, a Phase 3 study in coronary artery disease and angina with 2,651 patients, and NCT01163734, a Phase 2 study in diastolic heart failure with 20 patients.

Is Ranolazine the same as Ranexa?

Ranolazine is the generic name for the drug marketed as Ranexa, which is used to treat chronic angina. The clinical trials listed here evaluate ranolazine as the active ingredient, and the drug is being investigated for additional indications beyond its approved angina use.