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A Multi-Center, Open-Label, Multiple Dose, Dose Finding Study Exploring the Safety and Tolerability of Beraprost Sodium Modified Release in PAH Patients

Primary Purpose

Pulmonary Arterial Hypertension

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Beraprost sodium modified release
Sponsored by
Lung Biotechnology PBC
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pulmonary Arterial Hypertension

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Is male or female between the ages of 18 and 75 years of age, inclusive;
  2. Has either idiopathic or familial PAH, PAH associated with collagen vascular disease, or PAH induced by anorexigens;
  3. Is clinically stable, as determined by the investigator;
  4. Has previously undergone a cardiac catheterization which is consistent with PAH, specifically PAPm ≥25 mmHg (at rest), PCWP (or left ventricular end diastolic pressure) ≤15 mmHg, and PVR >3 wood units;
  5. Has been on a course of an endothelin receptor antagonist (ERA) or phosphodiesterase inhibitor (PDE-5) or the combination for at least 90 days at the time of the Baseline visit;
  6. Has an unencouraged six-minute walk distance (6MWD) between 300 and 600 meters at the Screening visit;
  7. Is able to communicate effectively with study personnel;
  8. Is considered to be reliable, willing, cooperative and compliant with the study protocol requirements;
  9. Provides voluntary, written informed consent before participating in the study;
  10. Is, if female, physiologically incapable of childbearing or is practicing an acceptable method of birth control (i.e., surgical sterilization, approved hormonal contraceptives, barrier methods [such as a condom or diaphragm] used with a spermicide, or an intrauterine device).

Exclusion Criteria:

  1. Has pulmonary venous hypertension, pulmonary veno-occlusive disease, pulmonary capillary hemangiomatosis, severe chronic obstructive pulmonary disease, pulmonary hypertension related to congenital heart disease, or chronic thromboembolic pulmonary hypertension;
  2. Is pregnant or lactating;
  3. Has a known intolerance to beraprost sodium or prostanoids;
  4. Has a pre-existing condition that could interfere with the absorption, distribution, metabolism, or excretion of drugs;
  5. Current use of tobacco products;
  6. Known history of syncope;
  7. Has, in the opinion of the Investigator, any concomitant disease other than those accepted as part of the inclusion criteria that would compromise the patient or the study;
  8. Has had a change in or discontinued any PAH medication (with the exception of anticoagulants) within 30 days prior to the Baseline visit;
  9. Has received any prostanoid therapy within the 30 days prior to the Baseline visit or be scheduled to receive additional prostanoid therapy during the study except for acute vasodilatory testing;
  10. Has received any investigational medication within 30 days prior to the Baseline visit or be scheduled to receive another investigational drug during the course of this study;
  11. In the opinion of the investigator, may be unable to comply with the study protocol;
  12. Has any preexisting disease known to cause pulmonary hypertension (e.g., obstructive lung disease, parasitic disease affecting the pulmonary system, sickle cell anemia, mitral valve stenosis, portal hypertension) other than those listed in the inclusion criteria;
  13. Has donated blood or plasma or has lost a volume of blood >450 mL within six weeks prior to the Baseline visit.
  14. Has an ongoing hemorrhagic condition (e.g. upper digestive track hemorrhage, hemoptysis, etc.) or has a pre-existing condition that, in the investigator's judgement, may increase the risk for developing hemorrhage during the study (e.g. hemophilia). However, transient hemorrhage (e.g. epistaxis, normal menstrual bleeding, gingival bleeding, hemorrhoidal hemorrhage, etc.) would not preclude enrollment

Sites / Locations

  • Harbor-UCLA Medical Center
  • Allegheny General Hospital
  • UTSW Medical Center
  • Universite Libre de Bruxelles, Hospital Erasme
  • Gastuiberg University Hospital
  • Mater Misericordiae University Hospital Ltd.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD) of BPS-MR in Pulmonary Arterial Hypertension (PAH) Patients, Following Chronic, Twice-daily Administration.

Secondary Outcome Measures

Number of Participants That Reported at Least One Treatment-Emergent Adverse Event (TEAE)
A treatment-emergent adverse event (TEAE) is defined as an event not present prior to the initiation of the treatment or any event already present that worsens in either intensity or frequency following exposure to the treatment. AEs occurring more than 3 days after the last day study drug was taken in the study was not included in the statistical analyses or summaries (except for subjects with adverse events leading to study drug withdrawn). Only TEAEs that occurred during the treatment period of the BPS-MR-PAH-201 study were summarized. Any adverse event starting prior to the first dose of study drug was excluded from the summary analyses and only presented in the data listings. All efficacy results are descriptive; no statistical analysis was conducted
Change in Body Mass Index (BMI) From Baseline to Week 19
Body Mass Index (BMI) was assessed at each study visit and taken after five minutes of seated rest. Body mass index is a value derived from the mass and height of a person. The BMI is defined as the body mass divided by the square of the body height, and is universally expressed in units of kg/m², resulting from mass in kilograms and height in meters.
Change in Weight From Baseline to Week 19
Weight was assessed at each study visit and taken after five minutes of seated rest. Weight was measured in kilograms (kg).
Change in Heart Rate From Baseline to Week 19
Heart Rate was assessed at each study visit and taken after five minutes of seated rest. Heart rate is measured in beats per minute (BPM).
Change in Body Temperature From Baseline to Week 19
Body Temperature was assessed at each study visit and taken after five minutes of seated rest. Body temperature was measured in degrees Celsius (C).
Change in Systolic Blood Pressure (SBP) From Baseline to Week 19
Systolic blood pressure was assessed at each study visit and taken after five minutes of seated rest. Systolic blood pressure was measured in millimeters of mercury (mmHg).
Change in Diastolic Blood Pressure (DBP) From Baseline to Week 19
Diastolic blood pressure was assessed at each study visit and taken after five minutes of seated rest. Diastolic blood pressure was measured in millimeters of mercury (mmHg).
Change in Respiratory Rate From Baseline to Week 19
Respiratory Rate was assessed at each study visit and taken after five minutes of seated rest. Respiratory rate was measured in breaths per minute.
Change in Electrocardiogram Intervals From Baseline to Week 19
Apparent Clearance (CL/F) of BPS-MR
Apparent clearance is defined as plasma clearance divided by absolute bioavailability per kilogram of bodyweight.
Apparent Volume of Distribution (Vz/F) of BPS-MR

Full Information

First Posted
October 27, 2008
Last Updated
June 3, 2020
Sponsor
Lung Biotechnology PBC
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1. Study Identification

Unique Protocol Identification Number
NCT00781885
Brief Title
A Multi-Center, Open-Label, Multiple Dose, Dose Finding Study Exploring the Safety and Tolerability of Beraprost Sodium Modified Release in PAH Patients
Official Title
A Multi-Center, Open-Label, Multiple Dose, Dose Finding Study Exploring the Safety and Tolerability of Beraprost Sodium Modified Release in PAH Patients
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Completed
Study Start Date
January 31, 2009 (Actual)
Primary Completion Date
September 30, 2010 (Actual)
Study Completion Date
September 30, 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lung Biotechnology PBC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is an international, open-label, multi-center, Phase II, multiple dose, dose-finding study to investigate the safety, tolerability and pharmacokinetic characteristics of BPS-MR tablets in male and female patients with PAH. Patients who meet the inclusion/exclusion criteria will enter the Treatment Phase at a Baseline visit. Patients will begin taking one BPS-MR tablet (60µg) twice daily (b.i.d.) escalating by one tablet b.i.d. each week to a maximum dose of 600µg (ten tablets) b.i.d or until the patient reaches their MTD. Following the achievement of the MTD, patients will be down-titrated off BPS-MR in weekly one tablet b.i.d. decrements. Patients may, alternatively, elect to continue taking the study drug at their MTD in a separate open-label extension study.
Detailed Description
This study is an international, open-label, multi-center, Phase II, multiple dose, dose-finding study to investigate the safety, tolerability and pharmacokinetic characteristics of BPS-MR tablets in male and female patients with PAH. All patients will be receiving background therapy with either a phosphodiesterase (PDE-5) inhibitor, endothelin receptor antagonist (ERA), or the combination of these two. The study is divided into two phases: The Treatment Phase and The Down-Titration Phase Screening will be conducted on an outpatient basis within 21 days prior to the Baseline visit. Patients meeting the inclusion/exclusion criteria at the Baseline visit will enter the Treatment Phase and begin taking one BPS-MR tablet (60µg) b.i.d. and escalating by one tablet b.i.d. each week to a maximum dose of 600µg (ten tablets) b.i.d. or until the patient reaches an intolerable dose. Patients who reach an intolerable dose will be instructed to continue treatment at the previous dose, which will be considered as their individual MTD. For example, if a patient attains a full week of six BPS-MR tablets b.i.d. (360µg) but is unable to tolerate seven tablets (420µg) then the patient will return to using six tablets of BPS-MR b.i.d. (360µg) for up to an additional week of treatment. In this scenario, BPS-MR 360µg b.i.d. is the patient's MTD. Patients who do not reach an intolerable dose and tolerate the full ten weeks of BPS-MR dosing will be considered to have their individual MTD as BPS-MR 600µg b.i.d. When patients reach their individual MTD (either at 10 weeks or earlier) they will return to the site 3-7 days after for an End of Treatment Phase assessment to be evaluated for safety and, optionally, a PK assessment. Subsequent to the End of Treatment Phase visit patients will be instructed to begin down-titration off of BPS-MR in weekly increments. However, patients may alternatively elect to continue taking BPS-MR at their MTD in a separate open-label extension study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Arterial Hypertension

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Beraprost sodium modified release
Intervention Description
Tablets 60mcg
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD) of BPS-MR in Pulmonary Arterial Hypertension (PAH) Patients, Following Chronic, Twice-daily Administration.
Time Frame
10 Weeks
Secondary Outcome Measure Information:
Title
Number of Participants That Reported at Least One Treatment-Emergent Adverse Event (TEAE)
Description
A treatment-emergent adverse event (TEAE) is defined as an event not present prior to the initiation of the treatment or any event already present that worsens in either intensity or frequency following exposure to the treatment. AEs occurring more than 3 days after the last day study drug was taken in the study was not included in the statistical analyses or summaries (except for subjects with adverse events leading to study drug withdrawn). Only TEAEs that occurred during the treatment period of the BPS-MR-PAH-201 study were summarized. Any adverse event starting prior to the first dose of study drug was excluded from the summary analyses and only presented in the data listings. All efficacy results are descriptive; no statistical analysis was conducted
Time Frame
19 Weeks
Title
Change in Body Mass Index (BMI) From Baseline to Week 19
Description
Body Mass Index (BMI) was assessed at each study visit and taken after five minutes of seated rest. Body mass index is a value derived from the mass and height of a person. The BMI is defined as the body mass divided by the square of the body height, and is universally expressed in units of kg/m², resulting from mass in kilograms and height in meters.
Time Frame
Baseline and 19 weeks
Title
Change in Weight From Baseline to Week 19
Description
Weight was assessed at each study visit and taken after five minutes of seated rest. Weight was measured in kilograms (kg).
Time Frame
Baseline and 19 weeks
Title
Change in Heart Rate From Baseline to Week 19
Description
Heart Rate was assessed at each study visit and taken after five minutes of seated rest. Heart rate is measured in beats per minute (BPM).
Time Frame
Baseline and 19 weeks
Title
Change in Body Temperature From Baseline to Week 19
Description
Body Temperature was assessed at each study visit and taken after five minutes of seated rest. Body temperature was measured in degrees Celsius (C).
Time Frame
Baseline and 19 weeks
Title
Change in Systolic Blood Pressure (SBP) From Baseline to Week 19
Description
Systolic blood pressure was assessed at each study visit and taken after five minutes of seated rest. Systolic blood pressure was measured in millimeters of mercury (mmHg).
Time Frame
Baseline and 19 weeks
Title
Change in Diastolic Blood Pressure (DBP) From Baseline to Week 19
Description
Diastolic blood pressure was assessed at each study visit and taken after five minutes of seated rest. Diastolic blood pressure was measured in millimeters of mercury (mmHg).
Time Frame
Baseline and 19 weeks
Title
Change in Respiratory Rate From Baseline to Week 19
Description
Respiratory Rate was assessed at each study visit and taken after five minutes of seated rest. Respiratory rate was measured in breaths per minute.
Time Frame
Baseline and 19 weeks
Title
Change in Electrocardiogram Intervals From Baseline to Week 19
Time Frame
Baseline and 19 weeks
Title
Apparent Clearance (CL/F) of BPS-MR
Description
Apparent clearance is defined as plasma clearance divided by absolute bioavailability per kilogram of bodyweight.
Time Frame
pre-dose and at 0.5, 1, 2, 3, 4, 5, 6, 8 and 12 hours post-dose on Day 67
Title
Apparent Volume of Distribution (Vz/F) of BPS-MR
Time Frame
pre-dose, 0.5, 1, 2, 3, 4, 5, 6, 8 and 12 hours post-dose on Day 67

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Is male or female between the ages of 18 and 75 years of age, inclusive; Has either idiopathic or familial PAH, PAH associated with collagen vascular disease, or PAH induced by anorexigens; Is clinically stable, as determined by the investigator; Has previously undergone a cardiac catheterization which is consistent with PAH, specifically PAPm ≥25 mmHg (at rest), PCWP (or left ventricular end diastolic pressure) ≤15 mmHg, and PVR >3 wood units; Has been on a course of an endothelin receptor antagonist (ERA) or phosphodiesterase inhibitor (PDE-5) or the combination for at least 90 days at the time of the Baseline visit; Has an unencouraged six-minute walk distance (6MWD) between 300 and 600 meters at the Screening visit; Is able to communicate effectively with study personnel; Is considered to be reliable, willing, cooperative and compliant with the study protocol requirements; Provides voluntary, written informed consent before participating in the study; Is, if female, physiologically incapable of childbearing or is practicing an acceptable method of birth control (i.e., surgical sterilization, approved hormonal contraceptives, barrier methods [such as a condom or diaphragm] used with a spermicide, or an intrauterine device). Exclusion Criteria: Has pulmonary venous hypertension, pulmonary veno-occlusive disease, pulmonary capillary hemangiomatosis, severe chronic obstructive pulmonary disease, pulmonary hypertension related to congenital heart disease, or chronic thromboembolic pulmonary hypertension; Is pregnant or lactating; Has a known intolerance to beraprost sodium or prostanoids; Has a pre-existing condition that could interfere with the absorption, distribution, metabolism, or excretion of drugs; Current use of tobacco products; Known history of syncope; Has, in the opinion of the Investigator, any concomitant disease other than those accepted as part of the inclusion criteria that would compromise the patient or the study; Has had a change in or discontinued any PAH medication (with the exception of anticoagulants) within 30 days prior to the Baseline visit; Has received any prostanoid therapy within the 30 days prior to the Baseline visit or be scheduled to receive additional prostanoid therapy during the study except for acute vasodilatory testing; Has received any investigational medication within 30 days prior to the Baseline visit or be scheduled to receive another investigational drug during the course of this study; In the opinion of the investigator, may be unable to comply with the study protocol; Has any preexisting disease known to cause pulmonary hypertension (e.g., obstructive lung disease, parasitic disease affecting the pulmonary system, sickle cell anemia, mitral valve stenosis, portal hypertension) other than those listed in the inclusion criteria; Has donated blood or plasma or has lost a volume of blood >450 mL within six weeks prior to the Baseline visit. Has an ongoing hemorrhagic condition (e.g. upper digestive track hemorrhage, hemoptysis, etc.) or has a pre-existing condition that, in the investigator's judgement, may increase the risk for developing hemorrhage during the study (e.g. hemophilia). However, transient hemorrhage (e.g. epistaxis, normal menstrual bleeding, gingival bleeding, hemorrhoidal hemorrhage, etc.) would not preclude enrollment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ted Staub, MS, MEng
Organizational Affiliation
Study Sponsor
Official's Role
Study Director
Facility Information:
Facility Name
Harbor-UCLA Medical Center
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States
Facility Name
Allegheny General Hospital
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15212
Country
United States
Facility Name
UTSW Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
8550
Country
United States
Facility Name
Universite Libre de Bruxelles, Hospital Erasme
City
Bruxelles
Country
Belgium
Facility Name
Gastuiberg University Hospital
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
Facility Name
Mater Misericordiae University Hospital Ltd.
City
Dublin
Country
Ireland

12. IPD Sharing Statement

Learn more about this trial

A Multi-Center, Open-Label, Multiple Dose, Dose Finding Study Exploring the Safety and Tolerability of Beraprost Sodium Modified Release in PAH Patients

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