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Oral Ifetroban to Treat Diffuse Cutaneous Systemic Sclerosis (SSc) or SSc-associated Pulmonary Arterial Hypertension

Primary Purpose

Scleroderma, Diffuse, Scleroderma, Systemic, Scleroderma, Limited

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Oral Ifetroban
Oral Placebo
Sponsored by
Cumberland Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Scleroderma, Diffuse focused on measuring Ifetroban, Scleroderma, Systemic Sclerosis

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Diffuse Cutaneous Criterion:

1. Systematic Sclerosis (SSc), as defined using the 2013 American College of Rheumatology/ European Union League Against Rheumatism Classification Criteria and dcSSc within 7 years following initial diagnosis as defined by the onset of the first non-Raynaud symptom.

SSc-PAH Criteria:

  1. Adults fulfilling the 2013 American College of Rheumatology/ European Union League Against Rheumatism Classification Criteria with confirmed SSc-PAH (limited or dcSSc) confirmed via previous cardiac catheterization
  2. Stable oral therapy for PAH for at least 30 days (monotherapy or combination)
  3. New York Heart Association (NYHA) Class I-III Heart Failure

Exclusion Criteria:

  1. Have a diagnosis of systemic sclerosis sine scleroderma;
  2. Be less than 18 years of age or greater than or equal to 80 years of age;
  3. Be pregnant, nursing, or planning to become pregnant;
  4. Current or planned treatment with prostanoid therapy;
  5. Current or planned treatment with pirfenidone;
  6. Use of rituximab in the last 3 months;
  7. Use of mycophenolic acid (Myfortic, CellCept) at a stable dose for less than 3 months;
  8. Current or planned corticosteroid therapy greater than 15mg per day of prednisone or prednisone equivalent;
  9. Significant lung disease, defined as FVC < 50% predicted or DLCO <40% predicted;
  10. Significant kidney disease, defined as Glomerular Filtration Rate (GFR) < 60 ml/min;
  11. Have moderate or severe hepatic impairment;
  12. Contraindication to MRI (e.g., implanted magnetic material, claustrophobia);
  13. Known hypersensitivity to gadolinium;
  14. Any cause of pulmonary hypertension other than World Health Organization (WHO) Group I associated with SSc;
  15. Use of aspirin > 81 mg per day in the last two weeks;
  16. Use of warfarin, heparin or other anticoagulants in the last 30 days;
  17. Recent (within 6 weeks) myocardial infarction or persistent atrial arrhythmias;
  18. Have a history of allergy or hypersensitivity to ifetroban;
  19. Have taken investigational drugs within 30 days before study treatment administration;
  20. Inability to understand the requirements of the study, inability to understand spoken English and abide by the study restrictions and to return for the required treatments and assessments;
  21. Be otherwise unsuitable for the study, in the opinion of the investigator.

Sites / Locations

  • The Universtity of Arizona Arthrtis CenterRecruiting
  • UCLARecruiting
  • New Life Medical Research Center, Inc.
  • Cleveland Clinic - FloridaRecruiting
  • Johns Hopkins UniversityRecruiting
  • Massachusetts General HospitalRecruiting
  • Boston University School of Medicine
  • Hospital for Special SurgeryRecruiting
  • Thomas Jefferson UniversityRecruiting
  • Medical University of South Carolina
  • Vanderbilt University Medical Center
  • Baylor Research InstituteRecruiting
  • Benaraoya Research Institute at Virginia Mason
  • KDH - Kokilaben Dhirubhai Ambani HospitalRecruiting
  • B. J. Government Medical CollegeRecruiting
  • PGIMERRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Patients with dcSSc

Patients with SSc-PAH

Arm Description

Patients with dcSSc will be randomized to receive either oral ifetroban or oral placebo daily for 365 days

Patients with SSc-PAH will be randomized to receive either oral ifetroban or oral placebo daily for 365 days

Outcomes

Primary Outcome Measures

Incidence of adverse events (AEs) and Serious AEs (SAEs)
Safety is measured using AEs, including clinical significant changes in vital signs, laboratory test abnormalities and clinical tolerability of ifetroban.

Secondary Outcome Measures

Change from baseline in forced vital capacity (FVC)
To determine if ifetroban improves pulmonary function in subjects with diffuse cutaneous SSc or SSc-PAH compared to placebo as measured by a change from baseline FVC.
Change from baseline in diffusion capacity for carbon monoxide (DLCO)
To determine if ifetroban improves pulmonary function in subjects with diffuse cutaneous SSc or SSc-PAH compared to placebo as measured by a change from baseline diffusion capacity for carbon monoxide (DLCO)
Change from baseline in the modified Rodnan skin score (mRSS)
The efficacy of treatment on skin fibrosis will be measured by changes from baseline in mRSS, a measure of skin thickness, at 52 weeks.

Full Information

First Posted
February 8, 2016
Last Updated
April 5, 2023
Sponsor
Cumberland Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02682511
Brief Title
Oral Ifetroban to Treat Diffuse Cutaneous Systemic Sclerosis (SSc) or SSc-associated Pulmonary Arterial Hypertension
Official Title
A Phase 2 Multicenter, Randomized, Double-blind, Placebo-controlled Study to Assess the Safety and Efficacy of Ifetroban in Patients With Diffuse Cutaneous Systemic Sclerosis (SSc) or SSc-associated Pulmonary Arterial Hypertension (SSc-PAH)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Recruiting
Study Start Date
January 2017 (Actual)
Primary Completion Date
December 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cumberland Pharmaceuticals

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this phase 2 multicenter, randomized, double-blind, placebo-controlled, study is to assess the safety and efficacy of ifetroban in patients with diffuse cutaneous systemic SSc (dcSSc) or SSc-associated pulmonary arterial hypertension (SSc-PAH).
Detailed Description
This study is a randomized, placebo-controlled, double-blind phase 2 trial of patients with dcSSc or SSc-PAH. Twenty participants with SSc-PAH and 14 participants with dcSSc will be randomized to receive either oral ifetroban daily or matching placebo. Study participants will be treated for 12 months, followed by a 30-day follow-up period. The study will test whether ifetroban is safe and statistically superior to placebo in reducing the effects of their disease at month 12 and explore the ability of ifetroban to prevent or reverse progression in patients with early disease duration and reverse established disease in patients with longer disease duration.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Scleroderma, Diffuse, Scleroderma, Systemic, Scleroderma, Limited, Sclerosis, Progressive Systemic, Skin Diseases, Connective Tissue Diseases, Pathologic Processes, Autoimmune Diseases
Keywords
Ifetroban, Scleroderma, Systemic Sclerosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
34 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Patients with dcSSc
Arm Type
Experimental
Arm Description
Patients with dcSSc will be randomized to receive either oral ifetroban or oral placebo daily for 365 days
Arm Title
Patients with SSc-PAH
Arm Type
Experimental
Arm Description
Patients with SSc-PAH will be randomized to receive either oral ifetroban or oral placebo daily for 365 days
Intervention Type
Drug
Intervention Name(s)
Oral Ifetroban
Other Intervention Name(s)
Ifetroban
Intervention Description
Subjects will be treated with oral ifetroban or placebo daily for 365 days
Intervention Type
Drug
Intervention Name(s)
Oral Placebo
Other Intervention Name(s)
Ifetroban
Intervention Description
Subjects will be treated with oral ifetroban or placebo daily for 365 days
Primary Outcome Measure Information:
Title
Incidence of adverse events (AEs) and Serious AEs (SAEs)
Description
Safety is measured using AEs, including clinical significant changes in vital signs, laboratory test abnormalities and clinical tolerability of ifetroban.
Time Frame
56 weeks
Secondary Outcome Measure Information:
Title
Change from baseline in forced vital capacity (FVC)
Description
To determine if ifetroban improves pulmonary function in subjects with diffuse cutaneous SSc or SSc-PAH compared to placebo as measured by a change from baseline FVC.
Time Frame
Baseline, 12, 26, and 52 weeks
Title
Change from baseline in diffusion capacity for carbon monoxide (DLCO)
Description
To determine if ifetroban improves pulmonary function in subjects with diffuse cutaneous SSc or SSc-PAH compared to placebo as measured by a change from baseline diffusion capacity for carbon monoxide (DLCO)
Time Frame
Baseline, 12, 26, and 52 weeks
Title
Change from baseline in the modified Rodnan skin score (mRSS)
Description
The efficacy of treatment on skin fibrosis will be measured by changes from baseline in mRSS, a measure of skin thickness, at 52 weeks.
Time Frame
Baseline, 12, 26, 39, and 52 weeks
Other Pre-specified Outcome Measures:
Title
Change from baseline in ventricular function as determined by cardiac MRI
Time Frame
Baseline, 26, and 52 weeks
Title
Change from baseline in ventricular function as determined by echocardiography
Time Frame
Baseline, 26, and 52 weeks
Title
Improve skin and peripheral vascular disease as measured by active digital ulcer count
Time Frame
Baseline, 12, 26, 39, and 52 weeks
Title
Improve skin and peripheral vascular disease as measured by the subject's self-assessment of pain in digits by a visual analog scale (VAS), if active digital ulcers are present.
Time Frame
Baseline, 12, 26, 39, and 52 weeks
Title
Change from baseline in blood biomarkers
Time Frame
Baseline, 26, and 52 weeks
Title
Change from baseline in skin biomarkers
Time Frame
Baseline, 26, and 52 weeks
Title
Change from baseline in erythrocyte sedimentation rate
Time Frame
Baseline, 26, and 52 weeks
Title
Change from baseline in subject-reported health status assessed by the Scleroderma Health Assessment Questionnaire (SHAQ)
Time Frame
Baseline, 12, 26, 39, and 52 weeks
Title
Change from baseline in subject health and disability measurements as assessed by the World Health Organization Disability Assessment Assessment Schedule 2.0 (WHODAS 2.0)
Time Frame
Baseline, 12, 26, 39, and 52 weeks
Title
Change from baseline in subject-reported gastro-intestinal tract symptoms as assessed by the University of California, Los Angles (UCLA) Scleroderma Clinical Trial Consortium (SCTC) Gastrointestinal Tract (GIT) Questionnaire
Time Frame
Baseline, 12, 26, 39, and 52 weeks
Title
Change from baseline in subject-reported outcomes as assessed by the short-form health survey (SF-36)
Time Frame
Baseline, 12, 26, 39, and 52 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diffuse Cutaneous Criterion: 1. Systematic Sclerosis (SSc), as defined using the 2013 American College of Rheumatology/ European Union League Against Rheumatism Classification Criteria and dcSSc within 7 years following initial diagnosis as defined by the onset of the first non-Raynaud symptom. SSc-PAH Criteria: Adults fulfilling the 2013 American College of Rheumatology/ European Union League Against Rheumatism Classification Criteria with confirmed SSc-PAH (limited or dcSSc) confirmed via previous cardiac catheterization Stable oral therapy for PAH for at least 30 days (monotherapy or combination) New York Heart Association (NYHA) Class I-III Heart Failure Exclusion Criteria: Have a diagnosis of systemic sclerosis sine scleroderma; Be less than 18 years of age or greater than or equal to 80 years of age; Be pregnant, nursing, or planning to become pregnant; Current or planned treatment with prostanoid therapy; Current or planned treatment with pirfenidone; Use of rituximab in the last 3 months; Use of mycophenolic acid (Myfortic, CellCept) at a stable dose for less than 3 months; Current or planned corticosteroid therapy greater than 15mg per day of prednisone or prednisone equivalent; Significant lung disease, defined as FVC < 50% predicted or DLCO <40% predicted; Significant kidney disease, defined as Glomerular Filtration Rate (GFR) < 60 ml/min; Have moderate or severe hepatic impairment; Contraindication to MRI (e.g., implanted magnetic material, claustrophobia); Known hypersensitivity to gadolinium; Any cause of pulmonary hypertension other than World Health Organization (WHO) Group I associated with SSc; Use of aspirin > 81 mg per day in the last two weeks; Use of warfarin, heparin or other anticoagulants in the last 30 days; Recent (within 6 weeks) myocardial infarction or persistent atrial arrhythmias; Have a history of allergy or hypersensitivity to ifetroban; Have taken investigational drugs within 30 days before study treatment administration; Inability to understand the requirements of the study, inability to understand spoken English and abide by the study restrictions and to return for the required treatments and assessments; Be otherwise unsuitable for the study, in the opinion of the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ingrid Anderson, PhD, CCRP
Phone
615-255-0068
Ext
250
Email
ianderson@cumberlandpharma.com
First Name & Middle Initial & Last Name or Official Title & Degree
Ines Macias-Perez, PhD
Phone
615-564-2188
Email
imaciasperez@cumberlandpharma.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Evan Brittain, MD
Organizational Affiliation
Vanderbilt University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Universtity of Arizona Arthrtis Center
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jazmin Dagnino
Email
jazmindagnino@arizona.edu
First Name & Middle Initial & Last Name & Degree
Jawad Bilal, MD
Facility Name
UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095-1670
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nashla Barroso
Phone
310-825-9682
First Name & Middle Initial & Last Name & Degree
Suzanne Kafaja, MD
Facility Name
New Life Medical Research Center, Inc.
City
Hialeah
State/Province
Florida
ZIP/Postal Code
33012
Country
United States
Individual Site Status
Withdrawn
Facility Name
Cleveland Clinic - Florida
City
Weston
State/Province
Florida
ZIP/Postal Code
33331
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marie Briceno, MD
Email
BRICENM@ccf.org
First Name & Middle Initial & Last Name & Degree
Lilian Cadet
Email
CADETL@ccf.org
First Name & Middle Initial & Last Name & Degree
Franck Rahaghi, MD
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21224
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gwen Leatherman, RN, MS, CCRP
Phone
410-550-8582
First Name & Middle Initial & Last Name & Degree
Laura Hummer, MD
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ana Frenandez
Phone
617-724-2792
First Name & Middle Initial & Last Name & Degree
Flavia Castelino, MD
Facility Name
Boston University School of Medicine
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02118
Country
United States
Individual Site Status
Withdrawn
Facility Name
Hospital for Special Surgery
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Beemnet Amdemicael
Phone
212-774-2123
First Name & Middle Initial & Last Name & Degree
Jessica Gordon, MD
Facility Name
Thomas Jefferson University
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marsha Simmons
Email
Marsha.Simmons@jefferson.edu
First Name & Middle Initial & Last Name & Degree
Fabian A Mendoza-Ballesteros, MD
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29403
Country
United States
Individual Site Status
Terminated
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Individual Site Status
Withdrawn
Facility Name
Baylor Research Institute
City
Dallas
State/Province
Texas
ZIP/Postal Code
75204-651
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Susan
First Name & Middle Initial & Last Name & Degree
Susan Mathai, MD
Facility Name
Benaraoya Research Institute at Virginia Mason
City
Seattle
State/Province
Washington
ZIP/Postal Code
98101
Country
United States
Individual Site Status
Withdrawn
Facility Name
KDH - Kokilaben Dhirubhai Ambani Hospital
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400053
Country
India
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gauri Pandit, MBBS
Email
Gauri.Pandit@relianceada.com
First Name & Middle Initial & Last Name & Degree
Sanchita Gupte, MBBS
Email
sanchita.gupte@relianceada.com
First Name & Middle Initial & Last Name & Degree
Sunil Singh, MBBS
Facility Name
B. J. Government Medical College
City
Pune
State/Province
Maharashtra
ZIP/Postal Code
411001
Country
India
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Vijaya Chavan
Email
orion.vijayachavan@gmail.com
First Name & Middle Initial & Last Name & Degree
Arohi Metkar
Email
Orion.arohi@gmail.com
Facility Name
PGIMER
City
Chandigarh
ZIP/Postal Code
160012
Country
India
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shefali Khanna, MD
First Name & Middle Initial & Last Name & Degree
Shashank Gaur
Email
ethicscare@ecrsindia.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Oral Ifetroban to Treat Diffuse Cutaneous Systemic Sclerosis (SSc) or SSc-associated Pulmonary Arterial Hypertension

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