Targeted Therapy With Glycogen Synthase Kinase-3 Inhibition for Arrhythmogenic Cardiomyopathy

Summary

The TaRGET study is a multi-centre, prospective, randomized, double-blind, placebo-controlled trial designed to evaluate the potential therapeutic efficacy of tideglusib, a glycogen synthase kinase-3 β inhibitor, in genotype positive arrhythmogenic cardiomyopathy.

Eligibility

Inclusion Criteria:

* A pathogenic or likely pathogenic desmosomal (PKP2, DSG2, DSC2, DSP, or JUP\*) rare variant OR the TMEM43-p.S358L variant

  \*JUP carriers must be homozygous or compound heterozygous
* Mean ≥ 500 PVCs per 24 hours on a baseline screening 7-day Holter monitor
* Clinical ACM diagnosis or recognition of genetic carrier status for ≥ 6 months prior to screening

Exclusion Criteria:

* NYHA class IV heart failure
* Ventricular scar secondary to coronary artery disease
* Initiation, cessation, or dose change of a Class I or III anti-arrhythmic drug in the 3 months prior to screening
* Any potentially harmful chronic liver disease
* ALT value \> 2X the upper limit of the normal reference range at Screening
* Total bilirubin value greater than the upper limit of the normal reference range at Screening, unless documented Gilbert's syndrome. For individuals with Gilbert's syndrome, total bilirubin value greater than 2-fold the upper limit of the normal reference range at Screening.
* A history of alcohol or illicit substance use disorders
* Regular and long-term use of strong CYP3A4 inhibitors, including clarithromycin, telithromycin, ketoconazole, itraconazole, posaconazole, nefazodone, idinavir and ritonavir
* Serum creatinine \> 150 micromole/L or creatinine clearance ≤ 60 mL/min (according to Cockcroft-Gault formula) at Screening
* Pregnant at time of enrollment and women of childbearing age who do not use a highly effective form of contraception
* Males, engaged in sexual relations with a female of child-bearing potential, not using an acceptable contraceptive method if not surgically sterile
* Patients unwilling to provide informed consent or comply with follow-up
* Hypersensitivity to tideglusib or any components of its formulation, including allergy to strawberry
* Concurrent use of drugs metabolized by CYP3A4 with a narrow therapeutic window e.g. warfarin and digoxin

Conditions3

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