Effect of Selexipag on Daily Life Physical Activity of Patients With Pulmonary Arterial Hypertension. (TRACE)
Pulmonary Arterial Hypertension
About this trial
This is an interventional other trial for Pulmonary Arterial Hypertension focused on measuring daily life, physical activity, actigraphy, PAH-SYMPACT
Eligibility Criteria
Inclusion Criteria:
- Male or female between 18 and 75 years old inclusive.
- Women of childbearing potential must have a negative serum pregnancy test at planned visits and use an acceptable method of birth control from screening up to 30 days after study treatment discontinuation.
Symptomatic pulmonary arterial hypertension (PAH) belonging to one of the following subgroups only:
- Idiopathic
- Heritable
- Drug or toxin induced
- Associated with one of the following: connective tissue disease; HIV infection; corrected simple congenital heart disease.
With the following hemodynamic characteristics assessed by right heart catheterization (RHC) prior to randomization:
- Mean pulmonary artery pressure (mPAP) ≥ 25 mmHg
- Pulmonary vascular resistance (PVR) ≥ 240 dyn•sec/cm5 (or 3 Wood Units)
- Pulmonary artery wedge pressure (PCWP) or left ventricular end-diastolic pressure (LVEDP) ≤ 15 mmHg.
- Treatment with an endothelin receptor antagonist (ERA) for at least 90 days and on a stable dose for 30 days prior to randomization.
- If an ERA is given in combination with a phosphodiesterase-5 (PDE-5) inhibitor or soluble guanylate cyclase (sGC) stimulator, these treatments must be ongoing for at least 90 days and on a stable dose for 30 days prior to randomization.
- WHO functional class (FC) II or III at randomization
- 6-minute walk distance (6MWD) ≥ 100 m at screening.
- Ability to walk without a walking aid.
- Valid baseline data for daily life physical activity (DLPA) and PAH-SYMPACT®.
Exclusion Criteria:
- Patients on a PAH-specific monotherapy targeting the nitric oxide pathway (i.e. PDE-5 inhibitor or sGC stimulator).
- Patients treated with prostacyclin, prostacyclin analog or selexipag within 3 months prior to screening.
- Any hospitalization during the last 30 days prior to screening.
- Severe coronary heart disease or unstable angina.
- Documented severe hepatic impairment or severe renal insufficiency at screening.
- Participation in a cardio-pulmonary rehabilitation program based on exercise training within 8 weeks prior to screening
- Any factor or condition likely to affect full participation in the study or compliance with the protocol (such as adherence to protocol mandated procedures), as judged by the investigator.
Sites / Locations
- LA Biomedical Research Institute
- Northside Hospital
- Kentuckiana Pulmonary Research Center
- Tufts Medical Center, Pulmonary/Critical Care & Sleep
- University of Nebraska Medical Center, Pulmonary, Critical Care & Sleep Medicine Division
- NYU Winthrop Hospital
- UNC Pulmonary Speciality Clinic
- Duke University School of Medicine, Duke Pulmonary Vascular Disease center
- University of Cincinnati, Heart, Lung and Vascular Institute
- CCF- Akron General Medical Hospital
- Integris Baptist Medical Center
- University of Pennsylvania, Pulmonary Vascular Disease Program
- Vanderbilt University Medical Center, Care Medicine
- Methodist Clinical Trials
- University of Texas Health Science Center (San Antonio)
- Medizinische Universität Innsbruck (MUI), Abt. für Pneumologie, Haus 2
- Krankenhaus der Elisabethinen, Servicestelle Klinische Studien
- Hôpital Bicêtre, ervice de Pneumologie et Réanimation respiratoire
- CHRU de Lille - Hôpital Albert Calmette, Service de cardiologie
- Hospital Larrey CHU de Toulouse
- Universitätsklinikum Giessen
- Herzzentrum der Universität zu Köln, Klinik III für Innere Medizin
- Universitätsklinikum Leipzig AöR, Abteilung Pneumologie
- Katholisches Klinikum Lünen/Werne GmbH, Haus E
- Mater Misericordiae University Hospital
- Oslo University Hospital, dept of cardiology
- Centro Hospitalar e Universitário de Coimbra, Serviço de Cardiologia
- Hospital Geral de Santo António-DEFI
- Sahlgrenska University Hospital, Gothenburg
- Skåne University Hospital, VO Hjärt och Lungmedicin
- Kantonsspital St. Gallen, Klinik für Pneumologie und Schlafmedizin
- Universitaetsspital Zurich, Klinik für Pneumologie C HOER 11
- Papworth Hospital, Pulmonary Vascular Disease Unit
- Golden Jubilee National Hospital, Scottish Pulmonary Vascular Unit
- The Royal Free Hospital, Cardiology Department
- Royal Brompton Hospital, Hypertension
- Hammersmith Hospital
- Freeman Hospital, Cardiothoracic Department
- Royal Hallamshire Hospital, Pulmonary Vascular Medicine
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Selexipag
Placebo
Selexipag is up-titrated from Day 1 to Week 12 to the individualized highest tolerated dose (HTD), which can range from 200 mcg b.i.d. to 1600 mcg b.i.d., in 200 mcg steps starting with 200 mcg b.i.d. Then, the dose is increased in increments of 200 mcg b.i.d., usually at weekly intervals, depending on the dose tolerability. Up-titration is followed by a stable maintenance treatment period at the highest tolerated dose, from Week 13 to Week 24.
Regimen and titration scheme similar to those in the selexipag group