Effect of Switching From Cigarette Smoking to THS on Systemic Endothelial Function in Subjects With Established Atherosclerotic Disease
Primary Purpose
Cardiovascular Diseases, Smoking, Tobacco Use
Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Cigarette
THS
Smoking Abstinence
Sponsored by
About this trial
This is an interventional other trial for Cardiovascular Diseases focused on measuring Flow Mediated Dilation, Atherosclerosis
Eligibility Criteria
Main Inclusion Criteria:
- History of coronary artery disease, defined as documented CAD (stable) with coronary artery stenosis on coronary angiogram ≥50% (incl. Percutaneous Coronary Intervention (PCI) / Coronary artery bypass graft surgery (CABG)) in the medical history or previously documented acute coronary syndrome (ACS) / myocardial infarction occurring more than 1 month prior to V1. AND / OR, History of peripheral artery disease (PAD) defined as ABI <0.9 or TBI <0.6 or clinical diagnosis of chronic, symptomatic lower limb ischemia as defined by Fontaine's stages I, IIa and IIb.
- Body mass index (BMI) 17.6-40.0 kg/m2 and body weight > 50 kg (male) or 40 kg (female).
- Subject has a smoking history of at least 10 years.
- Subject has not used other tobacco and nicotine products apart from cigarettes on a daily basis over the past year prior to V1.
- Subject has been smoking ≥ 10 commercially available cigarettes/day on average (no brand restriction) for at least 1 year prior to V1 (based on self-reporting).
- For subjects not willing to quit smoking only: have been advised to quit smoking and informed of smoking risks and of cessation programs and is still not willing to quit during the study duration.
- Subjects willing to quit smoking only: willing to and set a target quit date (TQD) within the next 28 days at V1 as assessed by self-reported questions
Main Exclusion Criteria:
- Planned peripheral or coronary intervention or surgical procedure.
- Unstable angina pectoris.
- Critical limb ischemia (absolute peripheral pressures <50mmHg).
- Recent (< 30 days) PAD revascularization therapy prior to V1.
- Recent ACS / myocardial infarction or stroke / TIA <30 days prior to V1.
- Pre-existing symptomatic heart failure with reduced ejection fraction (EF<35%).
- Planned peripheral or coronary intervention or surgical procedure related to CAD or PAD.
- Subjects with spirometry values indicating chronic obstructive pulmonary disease (COPD) GOLD* Stage 3 or 4 (FEV1/FVC <0.7 & FEV1 <50% predicted [post-BD])
- Existing known serious infection or chronic inflammatory systemic disease (e.g., rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, uncontrolled diabetes (HbA1c ≥ 7.0 % [or ≥ 53.0 mmol/mol]) or uncontrolled hypertension (systolic blood pressure≥140 mmHg and / or diastolic blood pressure ≥90 mmHg., stage 4 and 5 chronic kidney disease, etc…).
- Currently active cancer or history of cancer within the last 5 years prior to V1.
- History of alcohol and / or drug abuse (other than tetrahydrocannabinol [THC]).
- Positive serology test (human immunodeficiency virus (HIV) 1/2), hepatitis B and / or C).
- Female subject is pregnant or breastfeeding, (a urine pregnancy test will be performed at V1 and V2)
- Previous participation in this study, or participation in an investigational study (drug or medical device) within 4 weeks before V1 (participation in observational studies/registries allowed)
- For women of childbearing potential, female subject who does not agree to using an acceptable method of effective contraception during the entire study.
[*Global Initiative for Obstructive Lung Disease]
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Active Comparator
Active Comparator
Arm Label
Cigarette
Tobacco Heating System
Smoking Abstinence
Arm Description
Smokers who self-selected to continue smoking cigarettes.
Smokers who self-selected to switch to THS use.
Smokers who self-selected to abstain from smoking.
Outcomes
Primary Outcome Measures
Flow mediated dilation
Change from baseline in flow mediated dilation (%FMD) of the brachial artery at 12 months before administration of a vasodilator (nitroglycerin)
Secondary Outcome Measures
Full Information
NCT ID
NCT05566678
First Posted
September 30, 2022
Last Updated
May 22, 2023
Sponsor
Philip Morris Products S.A.
1. Study Identification
Unique Protocol Identification Number
NCT05566678
Brief Title
Effect of Switching From Cigarette Smoking to THS on Systemic Endothelial Function in Subjects With Established Atherosclerotic Disease
Official Title
A 12-month, 3-group, Preference, Multi-center Study to Demonstrate the Effects of Switching From Cigarettes to Tobacco Heating System (THS) on Systemic Endothelial Function in Subjects With Established Atherosclerotic Disease
Study Type
Interventional
2. Study Status
Record Verification Date
May 2023
Overall Recruitment Status
Withdrawn
Why Stopped
The study was stopped before enrollment, after a feasibility review revealed we would be unable to measure the primary endpoint (flow mediated dilation - FMD) with a high degree of reproducibility and minimum variability in a multi-country setting.
Study Start Date
March 15, 2023 (Anticipated)
Primary Completion Date
March 31, 2023 (Anticipated)
Study Completion Date
March 31, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Philip Morris Products S.A.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to demonstrate improvement in flow mediated dilation (FMD), a functional endpoint associated with the progression of atherosclerosis, when switching from cigarettes to the Tobacco Heating System (THS) in subjects with peripheral arterial disease (PAD) and/or coronary artery disease (CAD). The study is planned to be conducted in the US, Europe, and Asia.
Detailed Description
The goal of this longitudinal study is to demonstrate improvement in FMD, a functional endpoint associated with the progression of atherosclerosis and a predictor of future cardiovascular (CV) events in subjects with PAD and/or CAD, when switching from cigarettes to THS. Other CV functional endpoints, or cardiovascular biomarkers of potential harm (BoPH) representative of different pathophysiologic pathways associated with increased CV risk in smokers with established atherosclerosis will be assessed. It is expected that the totality of the evidence from this study will show the potential of THS to slow down the progression of atherosclerosis, thus helping to delay a CV event, or delaying a secondary event.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cardiovascular Diseases, Smoking, Tobacco Use, Peripheral Arterial Disease, Coronary Artery Disease
Keywords
Flow Mediated Dilation, Atherosclerosis
7. Study Design
Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
A three-group ambulatory preference design, multi-center study
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Cigarette
Arm Type
Active Comparator
Arm Description
Smokers who self-selected to continue smoking cigarettes.
Arm Title
Tobacco Heating System
Arm Type
Active Comparator
Arm Description
Smokers who self-selected to switch to THS use.
Arm Title
Smoking Abstinence
Arm Type
Active Comparator
Arm Description
Smokers who self-selected to abstain from smoking.
Intervention Type
Other
Intervention Name(s)
Cigarette
Intervention Description
Subjects who self-selected to continue smoking their own preferred brand of commercially available cigarettes.
Intervention Type
Other
Intervention Name(s)
THS
Other Intervention Name(s)
Tobacco Heating System 3.0
Intervention Description
Subjects who self-selected to quit smoking during the study duration will switch from cigarettes to using THS.
Intervention Type
Other
Intervention Name(s)
Smoking Abstinence
Intervention Description
Subjects who self-selected to quit smoking may be prescribed Nicotine Replacement Therapy (NRT) to support them in remaining abstinent from use of any tobacco and nicotine containing products during the study. (Behavioral support will be provided to subjects to aid with abstinence.)
Primary Outcome Measure Information:
Title
Flow mediated dilation
Description
Change from baseline in flow mediated dilation (%FMD) of the brachial artery at 12 months before administration of a vasodilator (nitroglycerin)
Time Frame
From baseline to 12 months.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria:
History of coronary artery disease, defined as documented CAD (stable) with coronary artery stenosis on coronary angiogram ≥50% (incl. Percutaneous Coronary Intervention (PCI) / Coronary artery bypass graft surgery (CABG)) in the medical history or previously documented acute coronary syndrome (ACS) / myocardial infarction occurring more than 1 month prior to V1. AND / OR, History of peripheral artery disease (PAD) defined as ABI <0.9 or TBI <0.6 or clinical diagnosis of chronic, symptomatic lower limb ischemia as defined by Fontaine's stages I, IIa and IIb.
Body mass index (BMI) 17.6-40.0 kg/m2 and body weight > 50 kg (male) or 40 kg (female).
Subject has a smoking history of at least 10 years.
Subject has not used other tobacco and nicotine products apart from cigarettes on a daily basis over the past year prior to V1.
Subject has been smoking ≥ 10 commercially available cigarettes/day on average (no brand restriction) for at least 1 year prior to V1 (based on self-reporting).
For subjects not willing to quit smoking only: have been advised to quit smoking and informed of smoking risks and of cessation programs and is still not willing to quit during the study duration.
Subjects willing to quit smoking only: willing to and set a target quit date (TQD) within the next 28 days at V1 as assessed by self-reported questions
Main Exclusion Criteria:
Planned peripheral or coronary intervention or surgical procedure.
Unstable angina pectoris.
Critical limb ischemia (absolute peripheral pressures <50mmHg).
Recent (< 30 days) PAD revascularization therapy prior to V1.
Recent ACS / myocardial infarction or stroke / TIA <30 days prior to V1.
Pre-existing symptomatic heart failure with reduced ejection fraction (EF<35%).
Planned peripheral or coronary intervention or surgical procedure related to CAD or PAD.
Subjects with spirometry values indicating chronic obstructive pulmonary disease (COPD) GOLD* Stage 3 or 4 (FEV1/FVC <0.7 & FEV1 <50% predicted [post-BD])
Existing known serious infection or chronic inflammatory systemic disease (e.g., rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, uncontrolled diabetes (HbA1c ≥ 7.0 % [or ≥ 53.0 mmol/mol]) or uncontrolled hypertension (systolic blood pressure≥140 mmHg and / or diastolic blood pressure ≥90 mmHg., stage 4 and 5 chronic kidney disease, etc…).
Currently active cancer or history of cancer within the last 5 years prior to V1.
History of alcohol and / or drug abuse (other than tetrahydrocannabinol [THC]).
Positive serology test (human immunodeficiency virus (HIV) 1/2), hepatitis B and / or C).
Female subject is pregnant or breastfeeding, (a urine pregnancy test will be performed at V1 and V2)
Previous participation in this study, or participation in an investigational study (drug or medical device) within 4 weeks before V1 (participation in observational studies/registries allowed)
For women of childbearing potential, female subject who does not agree to using an acceptable method of effective contraception during the entire study.
[*Global Initiative for Obstructive Lung Disease]
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christelle Haziza, PhD
Organizational Affiliation
Philip Morris Products S.A.
Official's Role
Study Chair
12. IPD Sharing Statement
Plan to Share IPD
No
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Effect of Switching From Cigarette Smoking to THS on Systemic Endothelial Function in Subjects With Established Atherosclerotic Disease
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