AzTrials
AzTrials

Pulmonary Hypertension (World Health Organization Group 2)Phase 2Re-PHIRENCT05737940

A Study of AZD3427 in Participants With Heart Failure and Pulmonary Hypertension Group 2

A Phase 2 study testing AZD3427 in people with Pulmonary Hypertension (World Health Organization Group 2) and Heart Failure, run by AstraZeneca at 60 sites in 14 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 study is intended to assess the ability of AZD3427 to reduce pulmonary vascular resistance (PVR) after 24 weeks of treatment in participants with heart failure (HF) and pulmonary hypertension (PH) Group 2 Read more about this study

Who is it for?
Ages 18 to 130 years
What is being tested?
AZD3427
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
260 participants
Where
60 sitesin 14 countries
Study dates
24 Apr 2023to 25 Aug 2025
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 130 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participant must be ≥ 18 years of age inclusive.
  • Participants must have a pre-existing diagnosis of HF, NYHA function class (FC) II to IV, and a pre-existing diagnosis of PH-LHD or likely or intermediate probability of Pulmonary hypertension due to left heart disease (PH-LHD) as per 2022 Pulmonary hypertension due to left heart disease European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines. Participants must be on stable HF standard of care medication, including diuretics.
  • Participants must have a combination of echocardiographic parameters that show intermediate or high probability of PH as per 2022 ESC/ERS guidelines.
  • Participants must have an on-study elevated pulmonary artery pressure from RHC performed as per RHC manual provided by the Sponsor, at Screening Visit 2:
  • PAWP ≥ 15 mmHg
  • mPAP ≥ 20 mmHg
  • Minimum body weight of 45 kg (inclusive).
  • Capable and willing of giving signed informed consent.

Who cannot join

  • Diagnosis of PH in World Health Organization (WHO) Group 1, WHO Group 3, WHO Group 4, or WHO Group 5.
  • Historical or current evidence of a clinically significant disease or disorder.
  • Decompensated HF or hospitalisation due to decompensated HF.
  • Any contraindications to RHC.
  • History of hypersensitivity to SC injections or devices.
  • History of hypersensitivity to drugs with a similar chemical structure or class to AZD3427 or any component of AZD3427 drug product, or ongoing clinically important allergy/hypersensitivity.
Show all 12Show fewer
  • Known lung disease with Forced expiratory volume in the first second (FEV1) < 30% of predicted.
  • Congenital long QT syndrome.
  • Cardiac ventricular arrhythmia which requires treatment. Participants with atrial fibrillation or flutter and controlled ventricular rate are permitted.
  • History of or anticipated heart transplant or ventricular assist device implantation.
  • Any known planned (scheduled) highly invasive Cardiovascular (CV) procedure (eg, coronary revascularisation, ablation of atrial fibrillation/flutter, valve repair/replacement, aortic aneurysm surgery, etc).
  • Participants who have previously received AZD3427.

Trial locations and contacts

60 sites in 14 countries.

60 sites in 14 countries

United States7 sites
  • Research Site

    Baltimore, Maryland, 21287

  • Research Site

    Beverly Hills, California, 90211

  • Research Site

    La Jolla, California, 92093

  • Research Site

    New Haven, Connecticut, 06519

  • Research Site

    Omaha, Nebraska, 68198

  • Research Site

    Rock Hill, South Carolina, 29732

  • Research Site

    St Louis, Missouri, 63136

Other trials in United States

Canada7 sites
  • Research Site

    Edmonton, Alberta, T6G 2E1

  • Research Site

    Halifax, Nova Scotia, B3H 3A7

  • Research Site

    London, Ontario, N6A 5A5

  • Research Site

    Montreal, Quebec, H1T 1C8

  • Research Site

    Ottawa, Ontario, K1Y 4W7

  • Research Site

    Toronto, Ontario, M5G 2N2

  • Research Site

    Vancouver, British Columbia, V6Z 1Y6

Other trials in Canada

Japan7 sites
  • Research Site

    Bunkyō City, 113-8603

  • Research Site

    Kasugai-shi, 487-0016

  • Research Site

    Kure-shi, 737-8505

  • Research Site

    Nagoya, 466-8560

  • Research Site

    Sapporo, 060-8648

  • Research Site

    Sunto-gun, 411-8611

  • Research Site

    Toyama, 930-0194

Other trials in Japan

Italy6 sites
  • Research Site

    Brescia, 25123

  • Research Site

    Genoa, 16132

  • Research Site

    Marche, 60126

  • Research Site

    Milan, 20138

  • Research Site

    Milan, 20142

  • Research Site

    Trieste, 34149

Other trials in Italy

Poland6 sites
  • Research Site

    Bialystok, 15-276

  • Research Site

    Gdansk, 80-952

  • Research Site

    Krakow, 31-202

  • Research Site

    Warsaw, 02-005

  • Research Site

    Warsaw, 04-628

  • Research Site

    Wroclaw, 50-556

Other trials in Poland

China4 sites
  • Research Site

    Beijing, 100034

  • Research Site

    Changsha, 430033

  • Research Site

    Guangzhou, 510100

  • Research Site

    Kunming, 650051

Other trials in China

Germany4 sites
  • Research Site

    Berlin, 13353

  • Research Site

    Cologne, 50937

  • Research Site

    Frankfurt, 60596

  • Research Site

    Jena, 07747

Other trials in Germany

Spain4 sites
  • Research Site

    Majadahonda, 28222

  • Research Site

    Seville, 41009

  • Research Site

    Toledo, 45007

  • Research Site

    Valencia, 46026

Other trials in Spain

Czechia3 sites
  • Research Site

    Prague, 10034

  • Research Site

    Prague, 12808

  • Research Site

    Prague, 140 21

Other trials in Czechia

Netherlands3 sites
  • Research Site

    Deventer, 7416 SE

  • Research Site

    Heerlen, 6419 PC

  • Research Site

    Tilburg, 5022 GC

Other trials in Netherlands

United Kingdom3 sites
  • Research Site

    Cambridge, CB2 0AY

  • Research Site

    Clydebank, G81 4DY

  • Research Site

    London, SW3 6NP

Other trials in United Kingdom

Austria2 sites
  • Research Site

    Linz, 4020

  • Research Site

    Vienna, 1100

Other trials in Austria

Denmark2 sites
  • Research Site

    Aarhus, 8200

  • Research Site

    Copenhagen, 2100

Other trials in Denmark

Sweden2 sites
  • Research Site

    Gothenburg, 413 45

  • Research Site

    Huddinge, 141 57

Other trials in Sweden

About this study

Official title: A Phase IIb Randomised, Double-blind, Placebo-controlled, Multi-centre, Dose-ranging Study of AZD3427 in Participants With Heart Failure and Pulmonary Hypertension Due to Left Heart Disease (WHO Group 2)

This study is intended to assess the ability of AZD3427 to reduce pulmonary vascular resistance (PVR) after 24 weeks of treatment in participants with heart failure (HF) and pulmonary hypertension (PH) Group 2

Read the detailed description

This study is a randomized, placebo-controlled, multi-centre, dose-ranging study of AZD3427 in participants with heart failure and pulmonary hypertension due to left heart disease (World Health Organisation [WHO] Group 2).

Approximately 220 participants will be randomised to 4 treatment groups (in a 1:1:1:1 ratio) to receive a subcutaneous (SC) injection of AZD3427 or placebo every 2 weeks for 24 weeks.

This study will evaluate 3 dose levels of AZD3427: Dose A, Dose B, and Dose C. Dose modification is not applicable for this study.

The study will be conducted in approximately 60 study centres across an estimated 15 countries.

The study will include approximately 16 study visits: 2 visits during the Screening Period,13 visits during the Treatment Period, and one visit during the Follow-up Period.

The expected total duration of the study is 32 to 37 weeks, depending on the length of the Screening Period.

Being tested
AZD3427, Placebo
Keywords
Pulmonary Hypertension, Heart Failure, Left Heart Disease, WHO Group 2, Dose-ranging Study, Pulmonary vascular resistance
Medical subject headings
Hypertension, Pulmonary, Heart Failure

What participants receive

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

  • AZD3427Drug

    The participants will receive AZD3427 SC injection single dose of either Dose A or Dose B or Dose C every 2 weeks for 24 weeks.

  • PlaceboDrug

    The participants will receive SC injection of placebo single dose every 2 weeks for 24 weeks.

Study groups in NCT05737940
Study groupRoleWhat they receive
AZD3427 Dose AExperimentalThe participants will receive single dose of AZD3427 Dose A every 2 weeks for 24 weeks from Day 1 to Day 155.
Receives: Drug: AZD3427
AZD3427 Dose BExperimentalThe participants will receive single dose of AZD3427 Dose B every 2 weeks for 24 weeks from Day 1 to Day 155.
Receives: Drug: AZD3427
AZD3427 Dose CExperimentalThe participants will receive single dose of AZD3427 Dose C every 2 weeks for 24 weeks from Day 1 to Day 155.
Receives: Drug: AZD3427
PlaceboPlacebo comparatorThe participants will receive single dose of placebo every 2 weeks for 24 weeks from Day 1 to Day 155.
Receives: Drug: Placebo

What is being measured

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

  1. Change From Baseline in Pulmonary Vascular Resistance (PVR)

    The effect of AZD3427 compared with placebo on PVR parameter as measured by right heart catheterization (RHC-a procedure which allows measurement of blood pressure in the right side of the heart) after 24 weeks of treatment in participants with heart failure (HF) and pulmonary hypertension (PH) Group 2 was evaluated. PVR was calculated using formula, PVR=80* [Mean pulmonary arterial pressure[mPAP](mmHg)- Pulmonary artery wedge pressure[PAWP](mmHg)]/Cardiac output (L/min).

    Baseline was defined as last non-missing value prior to or on the date of first study intervention dose. PVR was originally measured in dynes·sec/cm⁵. For the statistical analysis, PVR values were log-transformed, and change from baseline was assessed on the log-transformed scale. Results were subsequently back-transformed and presented on the original scale as the ratio of post-baseline to baseline PVR. Therefore, the unit of measure for this endpoint is a ratio.

    The measure type is geometric mean ratio.

    Measured: Baseline to Week 25

Secondary outcomes (22)
  1. Change From Baseline in Mean Pulmonary Arterial Pressure (mPAP)

    The effect of AZD3427 compared with placebo on mPAP parameter as measured by RHC after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  2. Change From Baseline in Pulmonary Artery Wedge Pressure (PAWP)

    The effect of AZD3427 compared with placebo on PAWP parameter as measured by RHC after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated.

    Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention. PAWP was measured in mmHg. The analysis was done similar to the primary endpoint. Therefore, the unit of measure for this endpoint is a ratio.

    The measure type is geometric mean ratio.

    Measured: Baseline to Week 25

  3. Change From Baseline in Cardiac Output (CO) ECHO

    The effect of AZD3427 compared with placebo on CO parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  4. Change From Baseline in Left Ventricular Stroke Volume (LV SV)

    The effect of AZD3427 compared with placebo on LV SV parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  5. Change From Baseline in Left Ventricular Ejection Fraction (LVEF)

    The effect of AZD3427 compared with placebo on EF parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  6. Change From Baseline in Left Ventricular Global Longitudinal Strain (LVGLS)

    The effect of AZD3427 compared with placebo on LVGLS parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. LVGLS is measured by echocardiograohy.

    Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  7. Change From Baseline in Pulmonary Arterial Systolic Pressure (PASP)

    The effect of AZD3427 compared with placebo on PASP parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  8. Change From Baseline in Right Ventricle/Left Ventricle (RV/LV) Ratio

    The effect of AZD3427 compared with placebo on RV/LV parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  9. Change From Baseline in Right Ventricular Outflow Tract Acceleration Time (RVOT AT)

    The effect of AZD3427 compared with placebo on RVOT AT parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  10. Change From Baseline in Tricuspid Regurgitation Velocity (TRV)

    The effect of AZD3427 compared with placebo on TRV parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. TRV was measured by Echocardiography.

    Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  11. Change From Baseline in TAPSE/PASP [Tricuspid Annular Plane Systolic Excursion/ Pulmonary Arterial Systolic Pressure]

    The effect of AZD3427 compared with placebo on TAPSE/PASP parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  12. Change From Baseline in Systemic Vascular Resistance (SVR)

    The effect of AZD3427 compared with placebo on systemic vascular resistance parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. SVR was measured by Echocardipgraphy.

    Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  13. Change From Baseline in 6-minute Walking Distance (6MWD)

    The effect of AZD3427 compared with placebo on function and symptoms using 6MWD parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  14. Change From Baseline in Kansas City Cardiomyopathy Questionnaire Total Symptom Score (KCCQ TSS)

    The effect of AZD3427 compared with placebo on function and symptoms using KCCQ TSS parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. The score ranged from 0 to 100, where a higher score represents a better patient outcome. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  15. Number of Participants With Improved Change From Baseline in New York Heart Association Functional Class (NYHA FC)

    The effect of AZD3427 compared with placebo on function and symptoms using NYHA FC parameter after 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 25

  16. Change From Baseline in Serum Creatinine

    The effect of AZD3427 compared with placebo using serum creatinine parameter after 12 and 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention. Creatinine was measured in micromoles/liter. The analysis was done similar to the primary endpoint. Therefore, the unit of measure for this endpoint is a ratio.

    Measured: Baseline to Week 13 and Week 25

  17. Change From Baseline in N-terminal Prohormone of Brain Natriuretic Peptide (NT-proBNP)

    The effect of AZD3427 compared with placebo using NT-proBNP parameter after 12 and 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention. NT-ProBNP was measured in picomole/Liter. The analysis was done similar to the primary endpoint. Therefore, the unit of measure for this endpoint is a ratio.

    Measured: Baseline to Week 13 and Week 25

  18. Change From Baseline in Cystatin C

    The effect of AZD3427 compared with placebo using cystatin C parameter after 12 and 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention. Cystatin C was measured in milligram/deciliter. The analysis was done similar to the primary endpoint. Therefore, the unit of measure for this endpoint is a ratio.

    Measured: Baseline to Week 13 and Week 25

  19. Change From Baseline in eGFR (Estimated Glomerular Filtration Rate)

    The effect of AZD3427 compared with placebo using eGFR parameter after 12 and 24 weeks of treatment in participants with HF and PH Group 2 was evaluated. Baseline was defined as the last non-missing value prior to or on the same date as the administration of the first dose of study intervention.

    Measured: Baseline to Week 13 and Week 25

  20. AZD3427 Serum Concentration

    Serum concentration of AZD3427 was summarised by timepoints and dose level. This was done to evaluate the pharmacokinetics (PK) of AZD3427 after dosing in participants with HF and PH Group 2.

    Considering the approximately 13-14 days half-life of AZD3427, low or non-quantifiable serum concentrations at Week 31 are not unexpected. Therefore, the presentation of the Week 31 results, including the reported NA values, reflects the prespecified statistical handling of the data and the observed concentration profile.

    Measured: On Week 3, Week 5, Week 13, Week 19, Week 25 and Week 31

  21. Number of Participants With Presence of Anti-drug Antibodies (ADAs)

    The immunogenicity of AZD3427 was evaluated as measured by ADAs. The number of participants with treatment emergent (TE) ADA positive samples have been reported as they account for the ADA incidence during the study.

    Measured: From Day 1 up to Day 211

  22. Evaluation of Positive ADA Titer

    The immunogenicity of AZD3427 as measured by ADAs was evaluated. ADA titer was summarized descriptively as a continuous variable, with median, minimum and maximum values.

    The antibody titer for the TE-ADA positive (ADA incidence) participants have been reported. It is defined as the sum of treatment-induced ADA (post-baseline positive only) and treatment-boosted ADA.

    Combined timepoint is used in summary for subject-level overall ADA status (i.e. TE-ADA positive). The summary statistics were calculated based on the maximum post-baseline titre for each ADA-positive subject within each treatment group,'

    Measured: At Day 1, Day 15, Day 29, Day 85, Day 169 and Day 211.

Timeline

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

  1. First posted21 Feb 2023
  2. Study start24 Apr 2023
  3. Primary completion15 Jul 2025
  4. Study completion25 Aug 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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
260 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05737940
Sponsor's protocol ID
D8330C00003
Acronym
Re-PHIRE
Status last verified
Sep 2026
First submitted
20 Jan 2023
Last updated
27 Oct 2026
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal Vivli.org. All requests will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. "Yes", indicates that AZ are accepting requests for IPD, but this does not mean all requests will be approved.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing AZD3427 in people with Pulmonary Hypertension (World Health Organization Group 2) and Heart Failure, run by AstraZeneca at 60 sites in 14 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 8 inclusion and 12 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 27 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 60 sites in United States, Canada, Japan, Italy, Poland and 9 more countries. 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 phase mean?

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?

Yes. Results are posted in the registry (first posted 27 Oct 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Change From Baseline in Pulmonary Vascular Resistance (PVR) (time frame: Baseline to Week 25). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 27 Oct 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in