Study to Compare Triple Therapy (Oral Treprostinil, Ambrisentan, and Tadalafil) With Dual Therapy (Ambrisentan, Tadalafil, and Placebo) in Subjects With Pulmonary Arterial Hypertension
Primary Purpose
Pulmonary Arterial Hypertension
Status
Withdrawn
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Oral Treprostinil
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Pulmonary Arterial Hypertension focused on measuring PAH, Oral Treprostinil, dual therapy, 6 Minute Walk Test
Eligibility Criteria
Inclusion Criteria:
- Between 18 and 79 years of age, inclusive
- PAH that is idiopathic / heritable, PAH associated with connective tissue disease, HIV infection, repaired congenital systemic-to-pulmonary shunts (repaired > 1 year), or appetite suppressant / toxin use
- Receiving dual therapy (ambrisentan and tadalafil)
- Previous testing (e.g. right heart catheterization, echocardiography) consistent with diagnosis of PAH
Exclusion Criteria:
- Nursing or pregnant
- PAH due to conditions other than noted in the above inclusion criteria
- Received PAH-specific drug therapy for >2 years
- History of uncontrolled sleep apnea, severe liver disease, severe renal impairment, left sided heart disease, uncontrolled systemic hypertension
- Participated in an investigational drug or device study within 90 days prior to signing consent.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Active Comparator
Arm Label
Placebo
Active
Arm Description
Matching placebo (sugar pill)
Oral treprostinil sustained release tablet
Outcomes
Primary Outcome Measures
Change in 6-Minute Walk Distance (6MWD)
Secondary Outcome Measures
Compare the effects of triple therapy versus dual therapy on the time to clinical worsening
clinical worsening is defined by 1 of the following:
Death (all causes)
Hospitalization due to worsening PAH
Initiation of long-term parenteral therapy
Disease progression
Unsatisfactory long-term clinical response
Change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations From Baseline to Week 28
The level of this biomarker of the (NT-proBNP) serum concentration will be assessed to compare the severity of heart failure at Baseline and Week 28.
Number of Participants with a Change From Baseline World Health Organization (WHO) Functional Classification at Week 28.
The WHO Functional Class of pulmonary hypertension is a physical activity rating scale as follows: Class I: No limitation of physical activity. Class II: Slight limitation of physical activity. Class III: Marked limitation of physical activity. Class IV: Inability to carry out any physical activity without symptoms.
Change in Quality of Life (QoL) Assessment: Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) From Baseline to Week 28.
The CAMPHOR is a health related quality of life instrument validated for pulmonary hypertension that assesses impairment (symptoms), disability (activities) and quality of life. The questionnaire is divided into three sections; Symptoms (Scores 025; high scores indicate more symptoms), Activity (Score 030; low score indicates good functioning) and Quality of Life (025; high scores indicate poor QoL). The sum of these scores equates to the Total score (080). In the CAMPHOR scores, lower scores indicate improvements.
Full Information
NCT ID
NCT02999906
First Posted
December 19, 2016
Last Updated
October 31, 2017
Sponsor
United Therapeutics
1. Study Identification
Unique Protocol Identification Number
NCT02999906
Brief Title
Study to Compare Triple Therapy (Oral Treprostinil, Ambrisentan, and Tadalafil) With Dual Therapy (Ambrisentan, Tadalafil, and Placebo) in Subjects With Pulmonary Arterial Hypertension
Official Title
A Phase 3, Multicenter, Randomized, Double-blind, Placebo-controlled, Study to Compare the Efficacy and Safety of Triple Therapy (Oral Treprostinil, Ambrisentan, and Tadalafil) With Dual Therapy (Ambrisentan, Tadalafil, and Placebo) in Subjects With Pulmonary Arterial Hypertension
Study Type
Interventional
2. Study Status
Record Verification Date
October 2017
Overall Recruitment Status
Withdrawn
Why Stopped
For business reasons.
Study Start Date
October 2017 (Anticipated)
Primary Completion Date
December 2021 (Anticipated)
Study Completion Date
June 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
United Therapeutics
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
This is a multicenter, randomized (2:1 oral treprostinil: placebo), double-blind, placebo-controlled study in subjects with Pulmonary Arterial Hypertension (PAH) who are currently receiving background dual therapy (ambrisentan, tadalafil) for at least 30 days at randomization for their PAH. Once randomized, subjects will return for 5 study visits up to Week 28 during the blinded period. After the Week 28 Visit, eligible subjects will transition to the open-label period of the study for up to 20 weeks.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Arterial Hypertension
Keywords
PAH, Oral Treprostinil, dual therapy, 6 Minute Walk Test
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching placebo (sugar pill)
Arm Title
Active
Arm Type
Active Comparator
Arm Description
Oral treprostinil sustained release tablet
Intervention Type
Drug
Intervention Name(s)
Oral Treprostinil
Other Intervention Name(s)
treprostinil diethanolamine
Intervention Description
Sustained release oral tablets for three times daily administration
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
matching placebo (sugar pill)
Intervention Description
Placebo (sugar pill) for three times daily oral administration
Primary Outcome Measure Information:
Title
Change in 6-Minute Walk Distance (6MWD)
Time Frame
Baseline to Week 28
Secondary Outcome Measure Information:
Title
Compare the effects of triple therapy versus dual therapy on the time to clinical worsening
Description
clinical worsening is defined by 1 of the following:
Death (all causes)
Hospitalization due to worsening PAH
Initiation of long-term parenteral therapy
Disease progression
Unsatisfactory long-term clinical response
Time Frame
Baseline to Week 28
Title
Change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations From Baseline to Week 28
Description
The level of this biomarker of the (NT-proBNP) serum concentration will be assessed to compare the severity of heart failure at Baseline and Week 28.
Time Frame
Baseline to week 28
Title
Number of Participants with a Change From Baseline World Health Organization (WHO) Functional Classification at Week 28.
Description
The WHO Functional Class of pulmonary hypertension is a physical activity rating scale as follows: Class I: No limitation of physical activity. Class II: Slight limitation of physical activity. Class III: Marked limitation of physical activity. Class IV: Inability to carry out any physical activity without symptoms.
Time Frame
Baseline to week 28
Title
Change in Quality of Life (QoL) Assessment: Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) From Baseline to Week 28.
Description
The CAMPHOR is a health related quality of life instrument validated for pulmonary hypertension that assesses impairment (symptoms), disability (activities) and quality of life. The questionnaire is divided into three sections; Symptoms (Scores 025; high scores indicate more symptoms), Activity (Score 030; low score indicates good functioning) and Quality of Life (025; high scores indicate poor QoL). The sum of these scores equates to the Total score (080). In the CAMPHOR scores, lower scores indicate improvements.
Time Frame
Baseline to week 28
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Between 18 and 79 years of age, inclusive
PAH that is idiopathic / heritable, PAH associated with connective tissue disease, HIV infection, repaired congenital systemic-to-pulmonary shunts (repaired > 1 year), or appetite suppressant / toxin use
Receiving dual therapy (ambrisentan and tadalafil)
Previous testing (e.g. right heart catheterization, echocardiography) consistent with diagnosis of PAH
Exclusion Criteria:
Nursing or pregnant
PAH due to conditions other than noted in the above inclusion criteria
Received PAH-specific drug therapy for >2 years
History of uncontrolled sleep apnea, severe liver disease, severe renal impairment, left sided heart disease, uncontrolled systemic hypertension
Participated in an investigational drug or device study within 90 days prior to signing consent.
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Study to Compare Triple Therapy (Oral Treprostinil, Ambrisentan, and Tadalafil) With Dual Therapy (Ambrisentan, Tadalafil, and Placebo) in Subjects With Pulmonary Arterial Hypertension
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