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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Withdrawn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
Philip Morris Products S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Cardiovascular Diseases focused on measuring Flow Mediated Dilation, Atherosclerosis

Eligibility Criteria

40 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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

    First Posted
    September 30, 2022
    Last Updated
    May 22, 2023
    Sponsor
    Philip Morris Products S.A.
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    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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