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A Study to Evaluate the Efficacy of an Oral Medication in the Treatment and Prevention of Digital Ulcers in Patients With Systemic Sclerosis (Scleroderma).

Primary Purpose

n Ulcer, Scleroderma, Systemic

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Ambrisentan
Sponsored by
Stanford University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for n Ulcer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of limited or diffuse systemic sclerosis (SSc) according to American College of Rheumatology or LeRoy criteria
  • Age greater than 18 years of age
  • At least one digital ulcer located on the volar or lateral surface at or distal to the proximal interphalangeal joints
  • At least one new DU that developed within 12 weeks prior to screening
  • Vasodilator therapies, including calcium channel blockers, alpha-1-antagonists, ACE-inhibitors, nitroglycerin, and angiotensin receptor blockers, are permitted as long as the doses are stable for 2 weeks prior to screening and throughout the study
  • Treatment with omeprazole or other proton pump inhibitors must be stable for 2 weeks prior to screening and throughout the study

Exclusion Criteria:

  • Patients with pulmonary arterial hypertension, NYHA Class III or IV
  • Patients who are hemodynamically unstable, or have acute renal, cardiac or pulmonary failure
  • Concurrent malignancy except non-melanoma skin cancers
  • Patients who have required systemic antibiotics for infected digital ulcers within 2 weeks of screening
  • Patients receiving phosphodiesterase-5 inhibitors, endothelin receptor antagonists, or prostanoids within 4 weeks of screening
  • Patients receiving cyclosporine within 6 weeks of screening
  • Patients who have participated in any investigational study within 30 days of screening
  • Pregnant or nursing women
  • Patients with a history of drug or alcohol abuse within 6 months of screening
  • History of hepatitis B, hepatitis C, or HIV infection
  • Any medical condition that, in the opinion of the investigator, might interfere with the subject's participation in the study or poses an added risk for the subject
  • Inability to comply with study and follow-up procedures
  • Transaminase elevation > 3X the upper limit of normal at screening
  • Hemoglobin less than 8.5 g/dL
  • Platelet count less than 100 X 109/L
  • White blood cell count less than 3.0 X 109/L
  • Serum creatinine less than 2.0 mg/dL

Sites / Locations

  • Stanford University School of Medicine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Active

Arm Description

Ambrisentan

Outcomes

Primary Outcome Measures

New Digital Ulcers (DU) 4 Weeks Prior to Week 24
The number of new digital ulcers (DU) that have developed in the preceding 4 weeks assessed at week 24 from baseline.

Secondary Outcome Measures

New DU 4 Weeks Prior to Week 12
The number of new DU that have developed in the preceding 4 weeks assessed at week 12 from baseline.
Subjects Experiencing Complete (Total Reepithelialization) Healing of All Baseline DU at Week 12.
Subjects Experiencing Complete Healing of > 50% of the Number of Baseline DU at Week 12.
Change in the Scleroderma Health Assessment Questionnaire (SHAQ) at Week 24 Compared With Baseline.
Range is 0-3 with 0 meaning the least amount of disability and 3 the greatest of disability.

Full Information

First Posted
July 28, 2008
Last Updated
March 1, 2017
Sponsor
Stanford University
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1. Study Identification

Unique Protocol Identification Number
NCT00725361
Brief Title
A Study to Evaluate the Efficacy of an Oral Medication in the Treatment and Prevention of Digital Ulcers in Patients With Systemic Sclerosis (Scleroderma).
Official Title
A Pilot Study to Evaluate the Efficacy of Ambrisentan in the Treatment and Prevention of Digital Ulcers in Patients With Systemic Sclerosis.
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Completed
Study Start Date
June 2008 (undefined)
Primary Completion Date
December 2010 (Actual)
Study Completion Date
December 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Stanford University

4. Oversight

5. Study Description

Brief Summary
This is a research study of an investigational drug called ambrisentan (Letairis) in the treatment and prevention of digital ulcers in patients with systemic sclerosis.
Detailed Description
Ambrisentan is an endothelin blocker approved for the treatment of pulmonary arterial hypertension. Patients with systemic sclerosis can have damage to their blood vessels, resulting in increased levels of endothelin in their bloodstream that then causes decreased blood flow to the digits. This can result in very painful digital ulcers. We hope to learn whether blocking the action of endothelin with ambrisentan will be helpful in the treatment and prevention of digital ulcers in patients with systemic sclerosis. This therapy is not approved for the treatment of systemic sclerosis, but this study will help us learn whether ambrisentan is safe and effective in the treatment and prevention of digital ulcers in patients with systemic sclerosis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
n Ulcer, Scleroderma, Systemic

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Active
Arm Type
Experimental
Arm Description
Ambrisentan
Intervention Type
Drug
Intervention Name(s)
Ambrisentan
Primary Outcome Measure Information:
Title
New Digital Ulcers (DU) 4 Weeks Prior to Week 24
Description
The number of new digital ulcers (DU) that have developed in the preceding 4 weeks assessed at week 24 from baseline.
Time Frame
4 weeks prior to week 24
Secondary Outcome Measure Information:
Title
New DU 4 Weeks Prior to Week 12
Description
The number of new DU that have developed in the preceding 4 weeks assessed at week 12 from baseline.
Time Frame
4 weeks prior to week 12
Title
Subjects Experiencing Complete (Total Reepithelialization) Healing of All Baseline DU at Week 12.
Time Frame
12 weeks
Title
Subjects Experiencing Complete Healing of > 50% of the Number of Baseline DU at Week 12.
Time Frame
12 weeks
Title
Change in the Scleroderma Health Assessment Questionnaire (SHAQ) at Week 24 Compared With Baseline.
Description
Range is 0-3 with 0 meaning the least amount of disability and 3 the greatest of disability.
Time Frame
24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of limited or diffuse systemic sclerosis (SSc) according to American College of Rheumatology or LeRoy criteria Age greater than 18 years of age At least one digital ulcer located on the volar or lateral surface at or distal to the proximal interphalangeal joints At least one new DU that developed within 12 weeks prior to screening Vasodilator therapies, including calcium channel blockers, alpha-1-antagonists, ACE-inhibitors, nitroglycerin, and angiotensin receptor blockers, are permitted as long as the doses are stable for 2 weeks prior to screening and throughout the study Treatment with omeprazole or other proton pump inhibitors must be stable for 2 weeks prior to screening and throughout the study Exclusion Criteria: Patients with pulmonary arterial hypertension, NYHA Class III or IV Patients who are hemodynamically unstable, or have acute renal, cardiac or pulmonary failure Concurrent malignancy except non-melanoma skin cancers Patients who have required systemic antibiotics for infected digital ulcers within 2 weeks of screening Patients receiving phosphodiesterase-5 inhibitors, endothelin receptor antagonists, or prostanoids within 4 weeks of screening Patients receiving cyclosporine within 6 weeks of screening Patients who have participated in any investigational study within 30 days of screening Pregnant or nursing women Patients with a history of drug or alcohol abuse within 6 months of screening History of hepatitis B, hepatitis C, or HIV infection Any medical condition that, in the opinion of the investigator, might interfere with the subject's participation in the study or poses an added risk for the subject Inability to comply with study and follow-up procedures Transaminase elevation > 3X the upper limit of normal at screening Hemoglobin less than 8.5 g/dL Platelet count less than 100 X 109/L White blood cell count less than 3.0 X 109/L Serum creatinine less than 2.0 mg/dL
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lorinda S Chung
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University School of Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Study to Evaluate the Efficacy of an Oral Medication in the Treatment and Prevention of Digital Ulcers in Patients With Systemic Sclerosis (Scleroderma).

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