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Heart Failure With Reduced Ejection FractionPhase 1/2GOAL-HF1NCT05642507

Phase Ib/IIa Trial With AC01 in Patients With HFrEF

A Phase 1/2 study testing AC01 in people with Heart Failure With Reduced Ejection Fraction, run by AnaCardio AB at 14 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This is a randomized, double-blind, placebo-controlled two-part study with a multiple escalating dose phase followed by a cohort expansion phase to assess safety, tolerability, pharmacokinetics and pharmacodynamics of AC01 in patients with heart failure with reduced ejection fraction (HFrEF). Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
AC01
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
58 participants
Where
14 sitesin 4 countries
Study dates
23 Feb 2023to 27 Oct 2025
Phase
Phase 1/2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male and female out-patients of any ethnicity, between 18-80 years (inclusive), with stable HFrEF.
  • Chronic HF for at least 6 months duration defined by history with current NYHA class II-III severity.
  • LVEF ≤40% by TTE more than 6 months before screening and again at screening (screening measurement confirmed by echocardiography core lab).
  • Sinus rhythm with mean resting heart rate 55-90 bpm.
  • Cardiac Index 0.5-2.4 measured by Innocor at screening and Day -1. Screening measurement confirmed by core lab.
  • Transvenous ICD for primary prevention in place and active (as long as it is not subcutaneous).
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  • Optimal guideline-based medical therapy for HFrEF as judged by the Investigator, at stable doses for ≥2 weeks with no intention to change dosing during trial duration.
  • Male and female out-patients of any ethnicity, between 18-80 years (inclusive), with stable HFrEF.
  • Chronic HF for at least 6 months duration defined by history with current NYHA class II-III severity.
  • LVEF ≤40% by TTE more than 6 months before screening and again at screening (screening measurement confirmed by echocardiography core lab).
  • Sinus rhythm or permanent, persistent or paroxysmal AFF (AFF at screening capped at ≥25% of enrolled patients) with mean resting heart rate 55-90 bpm measured as part of vital signs, at screening and on Day -1. Mean defined as mean of 3 separate measurements 1 minute apart.
  • Transvenous ICD for primary prevention in place and active (i.e., subcutaneous ICD not accepted).
  • Optimal guideline-based medical therapy for HFrEF as judged by the Investigator, at stable doses for ≥2 weeks with no intention to change dosing during trial duration.

Who cannot join

  • Any cardiac rhythm that does or could interfere with ECG or TTE interpretation, including but not limited to permanent or persistent atrial fibrillation or flutter or paroxysmal atrial fibrillation or flutter with an episode in the last 3 months, frequent premature ventricular contractions, or atrial or ventricular pacing
  • Ongoing or planned mechanical circulatory support, treatment with any IV vasoactive drugs (vasodilators, inotropes, or vasopressors) or diuretics, and/or dialysis or hemofiltration or ultrafiltration.
  • Probable alternative explanations for symptoms or signs (e.g., but not limited to, known primary cardiomyopathy [hypertrophic, constrictive, restrictive, infiltrative, congenital]). Primary uncorrected hemodynamically significant valve disease, right-sided HF not due to left-sided HF.
  • History of aborted cardiac arrest (cardiac arrest in the setting of myocardial infarction is allowed).
  • Hospitalized for HF or received IV diuretics, vasodilators, or inotropes for HF ≤30 days.
  • Clinical diagnosis of acute coronary syndrome or stroke ≤30 days.
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  • PCI or percutaneous valve intervention ≤30 days or planned.
  • Angina pectoris ≤30 days.
  • Any cardiovascular procedure planned during study duration.
  • Hospitalized or unplanned visit to the emergency department for any reason in last 30 days; patient is eligible 30 days from discharge from hospital.
  • Use of any drugs or substances known to be strong inducers of CYP3A4 enzyme within 28 days prior to the first dose of study drug and/or planned to be used during the overall study period until the day after the final dose of study drug (e.g., rifampin, phenytoin).
  • eGFR by CKD-EPI <30 mL/min/1.73 m2 at screening or at Day -1.
  • Serum or plasma potassium <3.5 or >5.2 mEq/L at screening or at Day -1. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3 times upper limit of normal (ULN) or total bilirubin >2 times ULN at screening or at Day -1 or known cirrhosis or severe liver or pancreatic disease, or Gilbert's syndrome.
  • Any condition that in the opinion of the Investigator may interfere with adherence to, or makes patient not suitable for, entry into the study.
  • Mean systolic blood pressure <90 mmHg or >140 mmHg, sitting after at least 5 minutes rest at screening or at Day -1.
  • Any of the following ECG findings at screening or at Day -1: atrial or ventricular pacing, QTcF >450 ms for males and >470 ms for females, AV block I with PQ >240 ms, AV block II or III. In the case of non-paced QRS prolongation >120 ms, the QTcF is allowed to be up to but not greater than 470 ms.
  • Any cardiac rhythm other than AFF that does or could interfere with ECG or TTE interpretation, including but not limited to >20% of ventricular contractions on ECG strips being premature ventricular contractions including doublets, triplets, bigeminy or trigeminy, or atrial or ventricular pacing.
  • Ongoing or planned mechanical circulatory support, treatment with any IV vasoactive drugs (vasodilators, inotropes, or vasopressors) or diuretics, and/or dialysis or hemofiltration or ultrafiltration.
  • Probable alternative explanations for symptoms or signs (e.g., but not limited to, known primary cardiomyopathy [hypertrophic, constrictive, restrictive, infiltrative, congenital]). Primary uncorrected hemodynamically significant valve disease, right-sided HF not due to left-sided HF.
  • History of aborted cardiac arrest (cardiac arrest in the setting of myocardial infarction is allowed).
  • Hospitalized for HF or received IV diuretics, vasodilators, or inotropes for HF ≤30 days.
  • Clinical diagnosis of acute coronary syndrome or stroke ≤30 days.
  • PCI or percutaneous valve intervention ≤30 days or planned.
  • Angina pectoris ≤30 days.
  • Any cardiovascular procedure planned during study duration.
  • Hospitalized for cardiovascular or other disease in last 30 days as per Investigator discretion; patient is eligible 30 days from discharge from hospital.
  • Use of any drugs or substances known to be strong inducers of CYP3A4 enzyme within 28 days prior to the first dose of study drug and/or planned to be used during the overall study period until the day after the final dose of study drug (e.g., rifampin, phenytoin).
  • eGFR by CKD-EPI <30 mL/min/1.73 m2 at screening.
  • Serum or plasma potassium >5.2 mEq/L at screening. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3 times upper limit of normal (ULN) or total bilirubin >2 times ULN at screening or at Day -1 or known cirrhosis or severe liver or pancreatic disease, or Gilbert's syndrome.
  • Any condition that in the opinion of the Investigator may interfere with adherence to, or makes patient not suitable for, entry into the study.
  • Mean systolic blood pressure <90 mmHg or >140 mmHg, sitting after at least 5 minutes rest at screening or at Day -1.
  • Any of the following ECG findings at screening or at Day -1: atrial or ventricular pacing, QTcF >450 ms for males and >470 ms for females, AV block I with PQ >240 ms, AV block II or III. In the case of non-paced QRS prolongation >120 ms, the QTcF is allowed to be up to but not greater than 470 ms.

Trial locations and contacts

14 sites in 4 countries.

14 sites in 4 countries

Netherlands5 sites
  • Amsterdam University Medical Centre

    Amsterdam, 1081 HV

  • University Medical Centre Groningen/ICON

    Groningen, 9718 GZ

  • Maastricht Heart and Vascular Center

    Maastricht, 6229 HX

  • Erasmus Medical Centre

    Rotterdam, 3015 GD

  • University Medical Center

    Utrecht

Other trials in Netherlands

United Kingdom4 sites
  • Ninewells Hospital and Medical School

    Dundee, DD1 9SY

  • University of Glasgow, Institute of Cardiovascular & Medical Sciences

    Glasgow, G12 8QQ

  • Golden Jubilee National Hospital

    Glasgow, G81 4DY

  • King's College Hospital

    London, SE5 9RS

Other trials in United Kingdom

Sweden3 sites
  • Sahlgrenska University Hospital

    Gothenburg, 413045

  • Skånes Universitetssjukhus Lund

    Lund, 222 42

  • Karolinska University Hospital

    Stockholm, 171 76

Other trials in Sweden

Italy2 sites
  • Spedali Civilia di Brescia

    Brescia, 25123

  • Azienda Sanitaria Universitaria Integrata

    Trieste, 34149

Other trials in Italy

About this study

Official title: Randomized, Double-blind, Multiple Ascending Dose, Placebo-controlled, Safety, Tolerability, Efficacy, Pharmacokinetic (PK) and Pharmacodynamic (PD) Phase Ib/IIa Clinical Trial With AC01 in Patients With HFrEF

This is a randomized, double-blind, placebo-controlled two-part study with a multiple escalating dose phase followed by a cohort expansion phase to assess safety, tolerability, pharmacokinetics and pharmacodynamics of AC01 in patients with heart failure with reduced ejection fraction (HFrEF).

Read the detailed description

During the dose escalation phase, patients were given AC01 orally twice daily for seven days. In the cohort expansion phase, patients were given AC01 orally twice daily for 28 days at dose levels selected on the basis of results of the dose escalation phase.

Being tested
AC01, Placebo Minitablets

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AC01Drug

    AC01 Minitablets

  • Placebo MinitabletsDrug

    Placebo Minitablets are indistinguishable from active AC01 Minitablets.

Study groups in NCT05642507
Study groupRoleWhat they receive
Cohort A1: Active (AC01) Minitablets 0.1 mgExperimentalParticipants will receive AC01 orally twice daily (BID) for 7 days.
Receives: Drug: AC01
Cohort A2: Active (AC01) Minitablets 0.3 mgExperimentalParticipants will receive AC01 orally twice daily (BID) for 7 days.
Receives: Drug: AC01
Cohort A3: Active (AC01) Minitablets 1 mgExperimentalParticipants will receive AC01 orally twice daily (BID) for 7 days.
Receives: Drug: AC01
Cohort A4: Active (AC01) Minitablets 3 mgExperimentalParticipants will receive AC01 orally twice daily (BID) for 7 days.
Receives: Drug: AC01
Placebo MinitabletsPlacebo comparatorParticipants will receive matching placebo orally BID for 7 days.
Receives: Drug: Placebo Minitablets
Cohort B1: Active (AC01) Minitablets 1 mgExperimentalParticipants will receive AC01 orally twice daily (BID) for 28 days.
Receives: Drug: AC01
Cohort B2: Active (AC01) Minitablets 3 mgExperimentalParticipants will receive AC01 orally twice daily (BID) for 28 days.
Receives: Drug: AC01
Cohort B3: Placebo MinitabletsPlacebo comparatorParticipants will receive matching placebo orally BID for 28 days.
Receives: Drug: Placebo Minitablets

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Safety and tolerability: Adverse Events (AEs)

    Number of participants with Treatment-emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Adverse Events of Special Interest (AESIs).

    Measured: From first dose of study drug up to end of follow up (up to 12 days during dose escalation phase and up to 35 days during cohort expansion phase).

  2. Safety and tolerability: Vital signs.

    Change from baseline in pulse rate.

    Measured: Baseline and end-of-treatment (Day 7 during the dose escalation and Day 28 during cohort expansion)

  3. Safety and tolerability: Vital signs.

    Change from baseline in systolic blood pressure.

    Measured: Baseline and end-of-treatment (Day 7 during the dose escalation and Day 28 during cohort expansion).

  4. Safety and tolerability: Vital signs.

    Change from baseline in body weight.

    Measured: Baseline and end-of-treatment (Day 7 during the dose escalation and Day 28 during cohort expansion).

  5. Safety and tolerability: Electrocardiogram (ECG).

    Number of participants with brady- or tachyarrhythmia.

    Measured: From first dose of study drug up to end of follow up (up to 12 days during dose escalation phase and up to 35 days during cohort expansion phase).

  6. Safety and tolerability: Electrocardiogram (ECG).

    Change from baseline in RR-, PR-, QRS- QTc intervals.

    Measured: Baseline and end-of-treatment (Day 7 during the dose escalation and Day 28 during cohort expansion).

  7. Safety and tolerability: Clinical laboratory evaluations.

    Change from baseline in N-terminal prohormone of Brain Natriuretic Peptide (NT-proBNP).

    Measured: Baseline and end-of-treatment (Day 7 during the dose escalation and Day 28 during cohort expansion).

  8. Safety and tolerability: Clinical laboratory evaluations.

    Change from baseline in hs-Troponin-I

    Measured: Baseline and end-of-treatment (Day 7 during the dose escalation and Day 28 during cohort expansion).

  9. Safety and tolerability: Clinical laboratory evaluations.

    Change from baseline in eGFR

    Measured: Baseline and end-of-treatment (Day 7 during the dose escalation and Day 28 during cohort expansion).

Secondary outcomes (3)
  1. Pharmacokinetics of AC01 and its major metabolite: Cmax.

    Maximal observed concentration (Cmax).

    Measured: Up to Day 8 during dose escalation phase and up to Day 32 during cohort expansion phase.

  2. Pharmacokinetics of AC01 and its major metabolite: AUC

    Area under the concentration-time curve.

    Measured: Up to Day 8 during dose escalation phase and up to Day 32 during cohort expansion phase.

  3. Pharmacodynamics: Mechanistic circulating biomarkers.

    Growth hormone (GH), cystatin C, insulin (fasting), aldosterone, cortisol, ACTH and prolactin.

    Measured: Up to 12 days during dose escalation phase and up to 35 days during cohort expansion phase.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Dec 2022
  2. Study start23 Feb 2023
  3. Primary completion27 Oct 2025
  4. Study completion27 Oct 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Sequential
Model description
Sequential, escalating, multiple doses
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
58 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05642507
Sponsor's protocol ID
AC01-01
Acronym
GOAL-HF1
Status last verified
May 2026
First submitted
18 Nov 2022
Last updated
7 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Disclosure of study data as per EU Clinical Trial Regulation principles. Publication of study data in peer-reviewed scientific journals. Individual de-identified participant data that underlie the results reported in this article, the study protocol and the clinical study report will be shared with qualified scientific and medical researchers whose proposed use of data has been approved by the study executive committee, beginning 9 months and ending 36 months following article publication.

Publications

  • Lund LH, Barandiaran Aizpurua A, Bollano E, Braun O, Brouwer JLP, Buikema JW, Cannata A, Gardner RS, Handoko ML, Lang CC, Metra M, Sinagra G, Thorvaldsen T, van der Boon RMA, van Essen BJ, Shah SJ, Voors AA, Lam CSP, Pitt B, Solomon SD, Hage C, Stahlberg M, Bernareggi A, Gordon A, Del Sole M, Rosendahl E, Stromberg P, Westerberg G, Edfors R, Petrie MC. Safety, pharmacokinetics, and exploratory efficacy of the oral ghrelin receptor agonist AC01 in heart failure with reduced ejection fraction (GOAL-HF1): a randomised, double-blind, placebo-controlled, phase 1b/2a study. Lancet. 2026 Jul 18;408(10551):248-262. doi: 10.1016/S0140-6736(26)00904-9. Epub 2026 Jun 24.

    PubMed 42341796

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing AC01 in people with Heart Failure With Reduced Ejection Fraction, run by AnaCardio AB at 14 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 32 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in Netherlands, United Kingdom, Sweden, Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Safety and tolerability: Adverse Events (AEs) (time frame: From first dose of study drug up to end of follow up (up to 12 days during dose escalation phase and up to 35 days during cohort expansion phase).). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05642507, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 May 2026.

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