A Study to Evaluate the Efficacy of an Oral Medication in the Treatment and Prevention of Digital Ulcers in Patients With Systemic Sclerosis (Scleroderma).

March 1, 2017 updated by: Lorinda S Chung, Stanford University

A Pilot Study to Evaluate the Efficacy of Ambrisentan in the Treatment and Prevention of Digital Ulcers in Patients With Systemic Sclerosis.

This is a research study of an investigational drug called ambrisentan (Letairis) in the treatment and prevention of digital ulcers in patients with systemic sclerosis.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Ambrisentan is an endothelin blocker approved for the treatment of pulmonary arterial hypertension. Patients with systemic sclerosis can have damage to their blood vessels, resulting in increased levels of endothelin in their bloodstream that then causes decreased blood flow to the digits. This can result in very painful digital ulcers. We hope to learn whether blocking the action of endothelin with ambrisentan will be helpful in the treatment and prevention of digital ulcers in patients with systemic sclerosis. This therapy is not approved for the treatment of systemic sclerosis, but this study will help us learn whether ambrisentan is safe and effective in the treatment and prevention of digital ulcers in patients with systemic sclerosis.

Study Type

Interventional

Enrollment (Actual)

20

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • California
      • Stanford, California, United States, 94305
        • Stanford University School of Medicine

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Diagnosis of limited or diffuse systemic sclerosis (SSc) according to American College of Rheumatology or LeRoy criteria
  • Age greater than 18 years of age
  • At least one digital ulcer located on the volar or lateral surface at or distal to the proximal interphalangeal joints
  • At least one new DU that developed within 12 weeks prior to screening
  • Vasodilator therapies, including calcium channel blockers, alpha-1-antagonists, ACE-inhibitors, nitroglycerin, and angiotensin receptor blockers, are permitted as long as the doses are stable for 2 weeks prior to screening and throughout the study
  • Treatment with omeprazole or other proton pump inhibitors must be stable for 2 weeks prior to screening and throughout the study

Exclusion Criteria:

  • Patients with pulmonary arterial hypertension, NYHA Class III or IV
  • Patients who are hemodynamically unstable, or have acute renal, cardiac or pulmonary failure
  • Concurrent malignancy except non-melanoma skin cancers
  • Patients who have required systemic antibiotics for infected digital ulcers within 2 weeks of screening
  • Patients receiving phosphodiesterase-5 inhibitors, endothelin receptor antagonists, or prostanoids within 4 weeks of screening
  • Patients receiving cyclosporine within 6 weeks of screening
  • Patients who have participated in any investigational study within 30 days of screening
  • Pregnant or nursing women
  • Patients with a history of drug or alcohol abuse within 6 months of screening
  • History of hepatitis B, hepatitis C, or HIV infection
  • Any medical condition that, in the opinion of the investigator, might interfere with the subject's participation in the study or poses an added risk for the subject
  • Inability to comply with study and follow-up procedures
  • Transaminase elevation > 3X the upper limit of normal at screening
  • Hemoglobin less than 8.5 g/dL
  • Platelet count less than 100 X 109/L
  • White blood cell count less than 3.0 X 109/L
  • Serum creatinine less than 2.0 mg/dL

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Active
Ambrisentan

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
New Digital Ulcers (DU) 4 Weeks Prior to Week 24
Time Frame: 4 weeks prior to week 24
The number of new digital ulcers (DU) that have developed in the preceding 4 weeks assessed at week 24 from baseline.
4 weeks prior to week 24

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
New DU 4 Weeks Prior to Week 12
Time Frame: 4 weeks prior to week 12
The number of new DU that have developed in the preceding 4 weeks assessed at week 12 from baseline.
4 weeks prior to week 12
Subjects Experiencing Complete (Total Reepithelialization) Healing of All Baseline DU at Week 12.
Time Frame: 12 weeks
12 weeks
Subjects Experiencing Complete Healing of > 50% of the Number of Baseline DU at Week 12.
Time Frame: 12 weeks
12 weeks
Change in the Scleroderma Health Assessment Questionnaire (SHAQ) at Week 24 Compared With Baseline.
Time Frame: 24 weeks
Range is 0-3 with 0 meaning the least amount of disability and 3 the greatest of disability.
24 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2008

Primary Completion (Actual)

December 1, 2010

Study Completion (Actual)

December 1, 2010

Study Registration Dates

First Submitted

July 28, 2008

First Submitted That Met QC Criteria

July 28, 2008

First Posted (Estimate)

July 30, 2008

Study Record Updates

Last Update Posted (Actual)

March 31, 2017

Last Update Submitted That Met QC Criteria

March 1, 2017

Last Verified

March 1, 2017

More Information

Terms related to this study

Other Study ID Numbers

  • SU-07222008-1265
  • IRB Protocol # 14409

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.