OncoSignal
Live from Open Targets Platform, fetched 2026-11-12 01:54 UTC. Every row links to its source record.

HCN4 hyperpolarization activated cyclic nucleotide gated potassium channel 4

ENSG00000138622 · protein coding · Open Targets profile

Hyperpolarization-activated ion channel that are permeable to Na(+) and K(+) ions with very slow activation and inactivation (PubMed:10228147, PubMed:10430953, PubMed:20829353). Exhibits higher selectivity for K(+) over Na(+) ions (PubMed:10228147). Contributes to the native pacemaker currents in heart (If) that regulate the rhythm of heart beat (Probable) (PubMed:10228147, PubMed:16407510, PubMed:19165230). Contributes to the native pacemaker currents in neurons (Ih) (Probable). May mediate responses to sour stimuli (By similarity). {ECO:0000250|UniProtKB:Q9JKA7, ECO:0000269|PubMed:10228147, ECO:0000269|PubMed:10430953, ECO:0000269|PubMed:16407510, ECO:0000269|PubMed:19165230, ECO:0000269|PubMed:20829353, ECO:0000305|PubMed:10430953}.

2 of the 4 drugs recorded against HCN4 are approved

Each band is a group of drugs. It runs from the kind of drug on the left to the furthest stage that drug has reached in any disease on the right. Thicker bands mean more drugs.

2 small molecule drugs at Approved: IVABRADINE HYDROCHLORIDE, DRONEDARONE HYDROCHLORIDE2 small molecule drugs at Withdrawn: IVABRADINE, DRONEDARONESmall molecule 4Approved 2Withdrawn 2

Approved bands are highlighted. Withdrawn means the drug was pulled from the market or from development. A combined phase counts as the later one (Phase 1/2 is shown as Phase 2). Hover a band for the drug names. Source: Open Targets Platform, fetched live.

Tractability

Small molecule
Approved Drug, Structure with Ligand, High-Quality Ligand, Med-Quality Pocket, Druggable Family
Antibody
UniProt loc high conf, GO CC high conf, UniProt SigP or TMHMM
PROTAC
Half-life Data, Small Molecule Binder

gnomAD loss of function constraint: o/e 0.37696999311447144 (upper bound 0.5139999985694885). Low values mean loss of function is poorly tolerated, a safety flag for inhibition.

Who runs trials of these drugs

Principal investigators and study chairs on 46 registry trials, updated in the last three years, of the most advanced drugs against HCN4 (ivabradine, dronedarone), ranked by Phase 2+ trials. Live from ClinicalTrials.gov.

15 of 42 trials of drugs against HCN4 have sites only in countries outside the US, China, Europe and Japan

Registry trials of ivabradine, dronedarone updated in the last three years, counted by the country group of their listed sites. A trial with sites in several groups counts in each; 39 of 42 have all sites in one country.

Sites only in this groupSites here and elsewhere
United StatesUnited States: 8 trials with sites only hereUnited States: 1 trials with sites here and elsewhere9ChinaChina: 6 trials with sites only hereChina: 0 trials with sites here and elsewhere6EuropeEurope: 11 trials with sites only hereEurope: 2 trials with sites here and elsewhere13OtherOther: 15 trials with sites only hereOther: 2 trials with sites here and elsewhere17

Site counts are not patients per country, and trials registered only outside ClinicalTrials.gov are not covered. Where sites are is a fact about the record, not a judgement of its quality. Europe is the EU and EEA, the UK and Switzerland. 4 trials list no sites and are left out. Source: ClinicalTrials.gov, fetched live.

17 trials of drugs against HCN4 were stopped early; 4 give no reason

Terminated, withdrawn and suspended interventional trials of ivabradine, dronedarone, newest update first, live from ClinicalTrials.gov. Each reason is quoted exactly as the registry gives it; we do not sort reasons into safety, efficacy or business. Dates are the last registry update. Showing the 17 most recent of 17.

  • terminated · 2026-09-11 · Phillip Levy · Ivabradine
    “Lack of patient enrollment”
  • terminated · 2025-10-30 · Tulane University School of Medicine · dronedarone 400 mg Oral Tablet
    “Sponsor withdrew funding”
  • terminated · 2025-02-06 · Atrial Fibrillation Network · matched by the registry's drug synonyms
    “following a recommendation from the data safety and monitoring board due to safety concerns and a tendency towards futility.”
  • withdrawn · 2024-12-12 · University of Maryland, Baltimore · Ivabradine
    “Unable to obtain funding”
  • terminated · 2022-02-10 · Dana-Farber Cancer Institute · Ivabradine
    “Funding terminated”
  • withdrawn · 2020-11-09 · Nanjing First Hospital, Nanjing Medical University · Ivabradine
    “Shortfall in funding”
  • terminated · 2020-08-17 · Bayside Health · Ivabradine
    No reason given
  • withdrawn · 2020-03-13 · Policlinico Casilino ASL RMB · Ivabradine plus beta-blocker (bisoprolol)
    “difficulties in recruiting patients”
  • withdrawn · 2018-11-19 · Amgen · Ivabradine
    “Sponsor decision”
  • withdrawn · 2018-08-17 · Liverpool Heart and Chest Hospital NHS Foundation Trust · Ivabradine
    “Funding not yet achieved”
  • withdrawn · 2014-11-25 · St Vincent's University Hospital, Ireland · Ivabradine
    “Difficulty recruit pts with PSHF HR > 70 \& high BNP.”
  • terminated · 2014-08-06 · Sanofi · Dronedarone, Placebo (for dronedarone)
    “'Sponsor decision following recruitment issues, not related to any safety concerns in the study”
  • terminated · 2013-04-11 · Sanofi · Dronedarone, Placebo (for Dronedarone)
    No reason given
  • terminated · 2013-02-12 · Sanofi · Dronedarone, Placebo (for Dronedarone)
    No reason given
  • terminated · 2012-10-26 · Sanofi · Dronedarone, Placebo (for Dronedarone)
    “The study was stopped because of safety concerns”
  • withdrawn · 2011-11-09 · Bayside Health · ivabradine
    No reason given
  • terminated · 2010-02-15 · Sanofi · Dronedarone (SR33589)
    “Terminated as the active treatment was associated with an increased hazard”
Paediatric incentives and obligations for HCN4's drugs

For ivabradine, dronedarone: what EMA and FDA publish about paediatric plans, orphan status and pediatric approvals, and how many registered studies take children. Each line is a yes, no or not published fact from the record linked under it; none of it is a forecast.

  • EU paediatric investigation plan: yes · EMEA-001743-PIP01-14 (carvedilol;ivabradine hydrochloride, Treatment of heart failure;Treatment of ischaemic coronary artery disorders): W: decision granting a waiver in all age groups for all conditions or indications, 7 Aug 2015; EMEA-001726-PIP01-14 (ranolazine;dronedarone, Treatment of supraventricular arrhythmias): W: decision granting a waiver in all age groups for all conditions or indications, 5 Jun 2015; EMEA-001405-PIP01-12 (metoprolol (tartrate);ivabradine hydrochloride, Treatment of ischaemic coronary artery disorders): W: decision granting a waiver in all age groups for all conditions or indications, 28 May 2013; EMEA-000627-PIP01-09-M04 (ivabradine hydrochloride, Treatment of angina pectoris;Treatment of chronic heart failure;Treatment of coronary artery disease): PM: decision on the application for modification of an agreed PIP, 30 Apr 2013; compliance positive 10 Oct 2014; +1 more
    Rule: An EMA PIP decision (agreement, modification or waiver) lists the drug as its active substance, exact name. Source: EMA data download (dated snapshot), 2026-11-11
  • EU orphan designation: no · No EU orphan designation names ivabradine, dronedarone
    Rule: An EU orphan designation lists the drug as its active substance (exact name) or belongs to a medicine that does; withdrawn and expired designations are listed with their status. Source: EMA data download (dated snapshot), 2026-11-11
  • Authorised in the EU: yes · Multaq: authorised since 25 Nov 2009; Ivabradine Anpharm: authorised since 8 Sept 2015; Corlentor: authorised since 25 Oct 2005; Procoralan: authorised since 25 Oct 2005; +4 more
    Rule: An EMA medicine record lists the drug as its active substance or INN, exact name; national-only authorisations are not in this file. Source: EMA data download (dated snapshot), 2026-11-11
  • FDA orphan designation: not published · FDA's orphan designation database turns away automated requests, so this app does not read it; search it by hand at the link
    Rule: Would be: an FDA orphan designation names the drug. Source: FDA orphan designations search
  • FDA pediatric oncology approval: no · FDA's table lists no pediatric approval of ivabradine, dronedarone
    Rule: FDA's Pediatric Oncology Drug Approvals table names the drug. Source: FDA Pediatric Oncology Drug Approvals (content current as of 2026-03-03), 2026-11-12
  • Registered studies open to children: yes · 6 interventional studies of ivabradine, dronedarone include patients under 18; 1 is recruiting, not yet recruiting or active
    Rule: The registry's age group includes Child (birth to 17 years), which also counts studies that set no minimum age. Source: ClinicalTrials.gov search, 2026-11-12

Rare pediatric disease voucher. FDA, content current as of 29 Apr 2026: “As of February 3, 2026, enactment of the Consolidated Appropriations Act, 2026, the rare pediatric disease PRV program will sunset after September 30, 2029. FDA may not award any PRVs under this program after September 30, 2029.” Voucher sale prices are not shown here; they appear only as company-reported news. FDA: Rare Pediatric Disease Designation and Priority Review Voucher Programs

All 4 drugs and clinical candidates as a table

Each drug, stage and indication links to its Open Targets record, where the trials and approvals behind it are listed. Salt forms (for example a mesylate) are listed as Open Targets records them, as separate entries.

DrugTypeHighest stageIndicationsSource records
IVABRADINE HYDROCHLORIDESmall moleculeapprovalcongestive heart failure, heart failureOpen Targets · ChEMBL
DRONEDARONE HYDROCHLORIDESmall moleculeapprovalatrial fibrillationOpen Targets · ChEMBL
IVABRADINESmall moleculewithdrawalangina pectoris, heart failure, cardiovascular disorder, mitral valve stenosis, Tachycardia, type 2 diabetes mellitus, coronary artery disorder, Moderate albuminuria, +20 moreOpen Targets · ChEMBL
DRONEDARONESmall moleculewithdrawalatrial fibrillation, cardiac arrhythmia, angina pectoris, atrial flutter, congestive heart failure, Paroxysmal atrial fibrillation, Ventricular arrhythmiaOpen Targets · ChEMBL