Tovinontrine fails to improve heart failure marker at the main dose in two trials

At the Heart Failure Society of America annual meeting, James Udelson reported that tovinontrine did not meet the primary endpoint in two phase II heart failure trials. The endpoint was change in NT-proBNP at 12 weeks. In the trial of 277 people with heart failure with preserved ejection fraction, the 50 mg twice-daily dose had a placebo-adjusted mean change of +9.4%.

Both trials showed increases in cyclic guanosine monophosphate, a marker of the drug's target engagement, according to Udelson. A post hoc analysis of the reduced-ejection-fraction trial suggested that lower doses may produce greater NT-proBNP reductions, but Udelson said the results should be considered hypothesis-generating. A phase IIb trial in reduced-ejection-fraction heart failure is planned for 2027. If those results support further development, investigators plan to test tovinontrine in preserved-ejection-fraction heart failure.