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Study of Efficacy and Safety of LTP001 in Pulmonary Arterial Hypertension

Primary Purpose

Pulmonary Arterial Hypertension

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
LTP001
Placebo
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pulmonary Arterial Hypertension focused on measuring Pulmonary Hypertension

Eligibility Criteria

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

Inclusion Criteria:

  • History of PAH belonging to one of the following subgroups of the Clinical Classification Group 1 (WHO):

    • participants with idiopathic pulmonary arterial hypertension (IPAH)
    • Hereditary pulmonary arterial hypertension
    • Congenital heart disease (surgically repaired at least 12 months prior to screening)
    • drug or toxin induced (for example, anorexigen, or methamphetamine use).
  • Resting mean pulmonary arterial pressure (mPAP) > 25 mmHg; pulmonary capillary wedge pressure (PCWP) or left ventricular end diastolic pressure < 15 mmHg, as determined by right heart catheterization within 20 days of randomization.
  • Pulmonary Vascular Resistance > 6 Wood units (480 dynes s/cm-5), as determined by right heart catheterization within 20 days of randomization.
  • WHO Functional Class II-III
  • 6MWD must be between 150 and 550 m (inclusive). The qualifying test needs to be within 20 days of randomization. To meet the above criterion additional six minute walk test (6MWT) may be performed up to a maximum of 3 tests in total prior to dosing; the minimal time difference between two tests should be at least 4 h.

    • Standard of care therapy which is stable at least 6 weeks prior to RHC and qualifying 6MWT assessment within 20 days of randomization. Standard of care includes one or more of the following treatments:
    • prostacyclin analogues and receptor agonists (if I.V., dose adjustments must be within 20% of initial stable dose)
    • endothelin receptor antagonists (ERAs)
    • phosphodiesterase type 5 inhibitors (PDE5i)
    • soluble guanylate cyclase (sGC) stimulators

Exclusion Criteria:

  • Participants with pulmonary hypertension (PH) in the Clinical Classification Groups 2-5 (WHO), and any PAH Group 1 subgroups not covered by Inclusion Criterion #4.
  • Participants with a history of left sided heart disease, chronic left sided heart failure, congenital or acquired valvular disease compromising left ventricular function and/or pulmonary venous hypertension or symptomatic coronary disease (non-symptomatic, revascularized coronary artery disease would be acceptable).
  • Participants with obstructive lung disease defined as: FEV1/FVC < 60% and FEV1 < 60% of predicted value after bronchodilator administration as well as participants with moderate or severe restrictive lung disease: Total Lung Capacity < 70% of predicted value. Testing must have occurred within 24months of screening. If historical testing is not available, then lung function testing must be conducted during the screening period.
  • Acute or chronic impairment (other than dyspnea), which would limit the ability to comply with study requirements, including interference with physical activity and execution of study procedures such as 6MWT (e.g., angina pectoris, claudication, musculoskeletal disorder, multiple sclerosis, need for walking aids).

Additional protocol-defined inclusion / exclusion criteria may apply.

Sites / Locations

  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

LTP001

Placebo

Arm Description

Participants will receive LTP001 orally once daily in the morning for approximately 24 weeks

Participants will receive LTP001 placebo capsules matching LTP001 orally once daily in the morning for approximately 24 weeks

Outcomes

Primary Outcome Measures

Change from baseline right heard catheterization Pulmonary vascular resistance (PVR) at week 25
PVR defined as the resistance against blood flow from the pulmonary artery to the left atrium measured in dyn.s.cm-5

Secondary Outcome Measures

Change from baseline in Six Minute Walk Distance (6MWD)
6MWD test measures the distance that a patient can quickly walk on a flat, hard surface in a period of 6 minutes
Change from baseline in Right Ventricle (RV) pressures at week 25
The Right Heart Catheterization (RHC) assessment is performed to assess several hemodynamic variables in pulmonary hypertension, including RV pressures.
Change from baseline in pulmonary capillary wedge pressure at week 25
The Right Heart Catheterization (RHC) assessment is performed to assess several hemodynamic variables in pulmonary hypertension, including pulmonary capillary wedge pressure (PCWP).
Change from baseline in pulmonary artery pressures at week 25
The Right Heart Catheterization (RHC) assessment is performed to assess several hemodynamic variables in pulmonary hypertension, including pulmonary artery pressure.
Change from baseline in Cardiac Output (CO) at week 25
The Right Heart Catheterization (RHC) assessment was performed to assess several hemodynamic variables in pulmonary hypertension, including Cardiac Output (CO).
Change from baseline in tricuspid annular plane systolic excursion (TAPSE)
Key Right Ventricular (RV) function endpoints such as Tricuspid Annular Plane Sys Excursion (TAPSE) are to be assessed with echocardiography.
Change from baseline in tricuspid annular systolic velocity (TASV)
Key Right Ventricular (RV) function endpoints such as tricuspid annular systolic velocity (TASV) are to be assessed with echocardiography.
Change from baseline of peak velocity of excursion (RV S')
Key Right Ventricular (RV) function endpoints such as peak velocity of excursion (RV S') are to be assessed with echocardiography.
Change from baseline in fractional area change (FAC)
Key Right Ventricular (RV) function endpoints such as RV fractional area change (RV FAC) are to be assessed with echocardiography.
Change from baseline in EmPHasis-10
emPHasis-10 is a questionnaire with 10 questions and is designed to determine how pulmonary hypertension affects a participant's life.
Change from baseline in PAH-SYMPACT
PAH-SYMPACT is a questionnaire used to assess pulmonary arterial hypertension symptoms and their impact.
Maximum Observed Blood Concentrations (Cmax) for LTP001
The maximum (peak) observed blood drug concentration after single dose administration (ng x mL-1)
Time to Reach Maximum Blood Concentrations (Tmax) of LTP001
The time to reach maximum (peak) blood drug concentration after single dose administration (h)
Time to Clinical Worsening
Time to any of the following: Death Hospital stay greater than 24 hours due to worsening of pulmonary arterial hypertension Worsening of PAH resulting in need for lung transplantation or balloon atrial septostomy Initiation of parenteral prostanoid therapy, initiation of oxygen therapy, initiation of any other pulmonary arterial hypertension-specific therapies or need for increase of diuretics for more than 4 weeks due to worsening of pulmonary arterial hypertension Disease progression Significant drop in six minute walk distance
Change from baseline in N-terminal fragment of the prohormone B-type natriuetic peptide (NT-ProBNP)
NT-proBNP is a blood biomarker to assess right ventricular distress.

Full Information

First Posted
November 16, 2021
Last Updated
October 9, 2023
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT05135000
Brief Title
Study of Efficacy and Safety of LTP001 in Pulmonary Arterial Hypertension
Official Title
A Randomized, Participant- and Investigator-blinded, Placebo-controlled Study to Investigate Efficacy, Safety, and Tolerability of LTP001 in Participants With Pulmonary Arterial Hypertension
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 30, 2022 (Actual)
Primary Completion Date
July 15, 2024 (Anticipated)
Study Completion Date
July 15, 2024 (Anticipated)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to explore the efficacy and safety of LTP001 in participants with pulmonary arterial hypertension (PAH) to determine if LTP001 has an adequate clinical profile to warrant further clinical development in this indication.
Detailed Description
This is a non-confirmatory, randomized, subject- and investigator-blinded, placebo controlled study of LTP001 in PAH participants. Approximately 44 male and female adults with PAH participants will be randomized in a 3:1 ratio of LTP001 active dose to placebo. Participants will be screened for up to 8 weeks followed by 24 weeks of daily dosing with visits approximately every 4 weeks. One follow up visit will also be the end of study visit and occurs approximately 30 days after the end of treatment. Total study duration is approximately 37 weeks from start of screening to end of study visit. If a participant continues into the open-label extension study, then the follow-up visit may be skipped.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
LTP001
Arm Type
Experimental
Arm Description
Participants will receive LTP001 orally once daily in the morning for approximately 24 weeks
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will receive LTP001 placebo capsules matching LTP001 orally once daily in the morning for approximately 24 weeks
Intervention Type
Drug
Intervention Name(s)
LTP001
Intervention Description
LTP001 will be administered orally once daily in the morning
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo to LTP001 will be administered once daily in the morning
Primary Outcome Measure Information:
Title
Change from baseline right heard catheterization Pulmonary vascular resistance (PVR) at week 25
Description
PVR defined as the resistance against blood flow from the pulmonary artery to the left atrium measured in dyn.s.cm-5
Time Frame
Baseline, week 25
Secondary Outcome Measure Information:
Title
Change from baseline in Six Minute Walk Distance (6MWD)
Description
6MWD test measures the distance that a patient can quickly walk on a flat, hard surface in a period of 6 minutes
Time Frame
Baseline, weeks 13 and 25
Title
Change from baseline in Right Ventricle (RV) pressures at week 25
Description
The Right Heart Catheterization (RHC) assessment is performed to assess several hemodynamic variables in pulmonary hypertension, including RV pressures.
Time Frame
Baseline, Week 25
Title
Change from baseline in pulmonary capillary wedge pressure at week 25
Description
The Right Heart Catheterization (RHC) assessment is performed to assess several hemodynamic variables in pulmonary hypertension, including pulmonary capillary wedge pressure (PCWP).
Time Frame
Baseline, Week 25
Title
Change from baseline in pulmonary artery pressures at week 25
Description
The Right Heart Catheterization (RHC) assessment is performed to assess several hemodynamic variables in pulmonary hypertension, including pulmonary artery pressure.
Time Frame
Baseline, Week 25
Title
Change from baseline in Cardiac Output (CO) at week 25
Description
The Right Heart Catheterization (RHC) assessment was performed to assess several hemodynamic variables in pulmonary hypertension, including Cardiac Output (CO).
Time Frame
Week 25
Title
Change from baseline in tricuspid annular plane systolic excursion (TAPSE)
Description
Key Right Ventricular (RV) function endpoints such as Tricuspid Annular Plane Sys Excursion (TAPSE) are to be assessed with echocardiography.
Time Frame
Baseline, weeks 5, 13 and 25
Title
Change from baseline in tricuspid annular systolic velocity (TASV)
Description
Key Right Ventricular (RV) function endpoints such as tricuspid annular systolic velocity (TASV) are to be assessed with echocardiography.
Time Frame
Baseline, weeks 5, 13 and 25
Title
Change from baseline of peak velocity of excursion (RV S')
Description
Key Right Ventricular (RV) function endpoints such as peak velocity of excursion (RV S') are to be assessed with echocardiography.
Time Frame
Baseline, weeks 5, 13 and 25
Title
Change from baseline in fractional area change (FAC)
Description
Key Right Ventricular (RV) function endpoints such as RV fractional area change (RV FAC) are to be assessed with echocardiography.
Time Frame
Baseline, weeks 5, 13 and 25
Title
Change from baseline in EmPHasis-10
Description
emPHasis-10 is a questionnaire with 10 questions and is designed to determine how pulmonary hypertension affects a participant's life.
Time Frame
Baseline, weeks 13 and 25
Title
Change from baseline in PAH-SYMPACT
Description
PAH-SYMPACT is a questionnaire used to assess pulmonary arterial hypertension symptoms and their impact.
Time Frame
Baseline, weeks 13 and 25
Title
Maximum Observed Blood Concentrations (Cmax) for LTP001
Description
The maximum (peak) observed blood drug concentration after single dose administration (ng x mL-1)
Time Frame
Weeks 1 and 25
Title
Time to Reach Maximum Blood Concentrations (Tmax) of LTP001
Description
The time to reach maximum (peak) blood drug concentration after single dose administration (h)
Time Frame
Weeks 1 and 25
Title
Time to Clinical Worsening
Description
Time to any of the following: Death Hospital stay greater than 24 hours due to worsening of pulmonary arterial hypertension Worsening of PAH resulting in need for lung transplantation or balloon atrial septostomy Initiation of parenteral prostanoid therapy, initiation of oxygen therapy, initiation of any other pulmonary arterial hypertension-specific therapies or need for increase of diuretics for more than 4 weeks due to worsening of pulmonary arterial hypertension Disease progression Significant drop in six minute walk distance
Time Frame
Baseline to Week 29
Title
Change from baseline in N-terminal fragment of the prohormone B-type natriuetic peptide (NT-ProBNP)
Description
NT-proBNP is a blood biomarker to assess right ventricular distress.
Time Frame
Baseline to Week 29

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: History of PAH belonging to one of the following subgroups of the Clinical Classification Group 1 (WHO): participants with idiopathic pulmonary arterial hypertension (IPAH) Hereditary pulmonary arterial hypertension Congenital heart disease (surgically repaired at least 12 months prior to screening) drug or toxin induced (for example, anorexigen, or methamphetamine use). Resting mean pulmonary arterial pressure (mPAP) > 25 mmHg; pulmonary capillary wedge pressure (PCWP) or left ventricular end diastolic pressure < 15 mmHg, as determined by right heart catheterization within 20 days of randomization. Pulmonary Vascular Resistance > 6 Wood units (480 dynes s/cm-5), as determined by right heart catheterization within 20 days of randomization. WHO Functional Class II-III 6MWD must be between 150 and 550 m (inclusive). The qualifying test needs to be within 20 days of randomization. To meet the above criterion additional six minute walk test (6MWT) may be performed up to a maximum of 3 tests in total prior to dosing; the minimal time difference between two tests should be at least 4 h. Standard of care therapy which is stable at least 6 weeks prior to RHC and qualifying 6MWT assessment within 20 days of randomization. Standard of care includes one or more of the following treatments: prostacyclin analogues and receptor agonists (if I.V., dose adjustments must be within 20% of initial stable dose) endothelin receptor antagonists (ERAs) phosphodiesterase type 5 inhibitors (PDE5i) soluble guanylate cyclase (sGC) stimulators Exclusion Criteria: Participants with pulmonary hypertension (PH) in the Clinical Classification Groups 2-5 (WHO), and any PAH Group 1 subgroups not covered by Inclusion Criterion #4. Participants with a history of left sided heart disease, chronic left sided heart failure, congenital or acquired valvular disease compromising left ventricular function and/or pulmonary venous hypertension or symptomatic coronary disease (non-symptomatic, revascularized coronary artery disease would be acceptable). Participants with obstructive lung disease defined as: FEV1/FVC < 60% and FEV1 < 60% of predicted value after bronchodilator administration as well as participants with moderate or severe restrictive lung disease: Total Lung Capacity < 70% of predicted value. Testing must have occurred within 24months of screening. If historical testing is not available, then lung function testing must be conducted during the screening period. Acute or chronic impairment (other than dyspnea), which would limit the ability to comply with study requirements, including interference with physical activity and execution of study procedures such as 6MWT (e.g., angina pectoris, claudication, musculoskeletal disorder, multiple sclerosis, need for walking aids). Additional protocol-defined inclusion / exclusion criteria may apply.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Novartis Pharmaceuticals
Phone
1-888-669-6682
Email
novartis.email@novartis.com
First Name & Middle Initial & Last Name or Official Title & Degree
Novartis Pharmaceuticals
Phone
+41613241111
Facility Information:
Facility Name
Novartis Investigative Site
City
Mesa
State/Province
Arizona
ZIP/Postal Code
85206
Country
United States
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Caba
State/Province
Buenos Aires
ZIP/Postal Code
C1025ABI
Country
Argentina
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Caba
State/Province
Buenos Aires
ZIP/Postal Code
C1280AEB
Country
Argentina
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Caba
State/Province
Buenos Aires
ZIP/Postal Code
C1426ABP
Country
Argentina
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Amsterdam
ZIP/Postal Code
1081
Country
Netherlands
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Krakow
ZIP/Postal Code
31 202
Country
Poland
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Lodz
ZIP/Postal Code
91-347
Country
Poland
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Wroclaw
ZIP/Postal Code
50-556
Country
Poland
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Malaga
State/Province
Andalucia
ZIP/Postal Code
29010
Country
Spain
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Santander
State/Province
Cantabria
ZIP/Postal Code
39008
Country
Spain
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Barcelona
State/Province
Catalunya
ZIP/Postal Code
08036
Country
Spain
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Sheffield
State/Province
South Yorkshire
ZIP/Postal Code
S10 2JF
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
London
ZIP/Postal Code
SW3 6HP
Country
United Kingdom
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Learn more about this trial

Study of Efficacy and Safety of LTP001 in Pulmonary Arterial Hypertension

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