A Study to Evaluate the Efficacy, Safety and Pharmacokinetics of Treprostinil Palmitil Inhalation Powder in Participants With Pulmonary Arterial Hypertension
A Phase 2b, Randomized, Double-Blind, Multicenter, Placebo-Controlled Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Treprostinil Palmitil Inhalation Powder in Participants With Pulmonary Arterial Hypertension
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Insmed Medical Information
- Phone Number: 1-844-446-7633
- Email: medicalinformation@insmed.com
Study Locations
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Cuiudad Autónoma de Buenos Aires, Argentina, C1430EGF
- ARG008
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Córdoba, Argentina, X5000FPQ
- ARG001
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Córdoba, Argentina, X5000DCE
- ARG004
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Buenos Aires
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Quilmes, Buenos Aires, Argentina, B1878GEG
- ARG009
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Santa Fe Province
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Rosario, Santa Fe Province, Argentina, S2013KDS
- ARG006
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Rosario, Santa Fe Province, Argentina, S2013DSR
- ARG002
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Tucumán Province
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San Miguel de Tucumán, Tucumán Province, Argentina, T4000AXL
- ARG007
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New South Wales
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New Lambton Heights, New South Wales, Australia, 2305
- AUS005
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Queensland
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Milton, Queensland, Australia, 4064
- AUS004
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Woolloongabba, Queensland, Australia, 4102
- AUS001
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South Australia
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Adelaide, South Australia, Australia, 5000
- AUS003
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Tasmania
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Hobart, Tasmania, Australia, 7000
- AUS002
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Vienna, Austria, 1090
- AUT001
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Upper Austria
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Linz, Upper Austria, Austria, 4020
- AUT002
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Liège, Belgium, 4000
- BEL001
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Brussels Capital
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Anderlecht, Brussels Capital, Belgium, 1070
- BEL003
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Vlaams Brabant
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Leuven, Vlaams Brabant, Belgium, 3000
- BEL002
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São Paulo, Brazil, 05403-000
- BRA001
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Minas Gerais
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Belo Horizonte, Minas Gerais, Brazil, 30130
- BRA003
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Belo Horizonte, Minas Gerais, Brazil, 30441-070
- BRA004
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Rio Grande do Sul
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Passo Fundo, Rio Grande do Sul, Brazil, 99010-120
- BRA007
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Porto Alegre, Rio Grande do Sul, Brazil, 90035-003
- BRA006
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Santa Catarina
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Blumenau, Santa Catarina, Brazil, 80440-080
- BRA002
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Central Jutland
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Aarhus N, Central Jutland, Denmark, 8200
- DNK001
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Berlin, Germany, 12683
- GER007
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Munich, Germany, 80639
- GER003
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Baden-Wurttemberg
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Heidelberg, Baden-Wurttemberg, Germany, 69126
- GER005
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Saxony
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Dresden, Saxony, Germany, 01307
- GER006
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Saxony-Anhalt
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Halle, Saxony-Anhalt, Germany, 6120
- GER001
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Schleswig-Holstein
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Lübeck, Schleswig-Holstein, Germany, 23562
- GER002
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Roma, Italy, 00161
- ITA004
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Campania
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Naples, Campania, Italy, 80131
- ITA003
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Lombardy
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Milan, Lombardy, Italy, 20123
- ITA006
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Monza, Lombardy, Italy, 20900
- ITA005
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Pavia, Lombardy, Italy, 27100
- ITA002
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Sicily
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Palermo, Sicily, Italy, 90127
- ITA001
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Hokkaidô
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Sapporo, Hokkaidô, Japan, 060-8543
- JPN005
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Sapporo, Hokkaidô, Japan, 060-8648
- JPN004
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Hukuoka
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Kurume-Shi, Hukuoka, Japan, 830-0011
- JPN007
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Ibaraki
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Tsukuba, Ibaraki, Japan, 305-8576
- JPN006
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Kagoshima-ken
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Kagoshima, Kagoshima-ken, Japan, 890-8520
- JPN001
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Nagasaki
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Nagasaki, Nagasaki, Japan, 852-8501
- JPN009
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Okayama-ken
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Okayama, Okayama-ken, Japan, 701-1154
- JPN002
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Tokyo
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Shinjuku-Ku, Tokyo, Japan, 160-8582
- JPN008
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Ôsaka
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Suita-Shi, Ôsaka, Japan, 564-8565
- JPN003
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Kedah
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Alor Star, Kedah, Malaysia, 05460
- MYS005
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Pahang
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Kuantan, Pahang, Malaysia, 25200
- MYS002
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Selangor
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Kajang, Selangor, Malaysia, 43000
- MYS003
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Sungai Buloh, Selangor, Malaysia, 47000
- MYS004
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San Luis Potosí City, Mexico, 78200
- MEX004
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Sertoma, Mexico, 64718
- MEX001
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Jalisco
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Lomas de Guevara, Jalisco, Mexico, 44657
- MEX005
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Mexico City
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Mexico City, Mexico City, Mexico, 14080
- MEX003
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Makati City, Philippines, 1229
- PHL002
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National Capital Region
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Quezon City, National Capital Region, Philippines, 1100
- PHL001
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Belgrade, Serbia, 11000
- SRB001
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Belgrade, Serbia, 11000
- SRB003
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Belgrade
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Belgrade, Belgrade, Serbia, 116550
- SRB004
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Barcelona, Spain, 8025
- ESP002
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Las Palmas, Spain, 35010
- ESP007
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Madrid, Spain, 28046
- ESP008
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Seville, Spain, 41009
- ESP003
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Toledo, Spain, 45007
- ESP004
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Balearic Islands
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Palma de Mallorca, Balearic Islands, Spain, 07010
- ESP006
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Cantabria
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Santander, Cantabria, Spain, 39008
- ESP001
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Vaud (fr)
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Lausanne, Vaud (fr), Switzerland, CH-1011
- CHE002
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London, United Kingdom, NW3 2Q
- GBR004
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Avon
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Bath, Avon, United Kingdom, BA1 3NG
- GBR001
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Lanarkshire
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Glasgow, Lanarkshire, United Kingdom, G81 4HX
- GBR002
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London, City of
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London, London, City of, United Kingdom, W12 0HS
- GBR006
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Tyne and Wear
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Newcastle upon Tyne, Tyne and Wear, United Kingdom, NE3 3HD
- GBR003
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Arizona
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Phoenix, Arizona, United States, 85006
- USA025
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Scottsdale, Arizona, United States, 85258
- USA022
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Tucson, Arizona, United States, 85724
- USA021
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California
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Sacramento, California, United States, 95817
- USA023
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West Hollywood, California, United States, 90048
- USA002
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Florida
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Gainesville, Florida, United States, 32610
- USA008
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Jacksonville, Florida, United States, 32224
- USA005
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Orlando, Florida, United States, 32803
- USA007
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Tampa, Florida, United States, 33601
- USA011
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Winter Park, Florida, United States, 32792-3800
- USA010
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Georgia
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Atlanta, Georgia, United States, 30309
- USA009
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Illinois
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Chicago, Illinois, United States, 60611
- USA006
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Chicago, Illinois, United States, 60612
- USA001
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Indiana
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Indianapolis, Indiana, United States, 46260
- USA013
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Iowa
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Iowa City, Iowa, United States, 52242
- USA014
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Kansas
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Kansas City, Kansas, United States, 66160
- USA003
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New York
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New York, New York, United States, 10021
- USA102
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New York, New York, United States, 10032-1559
- USA017
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Texas
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Dallas, Texas, United States, 75246
- USA016
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Denison, Texas, United States, 75020
- USA012
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Houston, Texas, United States, 77030
- USA018
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Participants must be ≥ 18 to ≤ 75 years at the time of signing the informed consent form (ICF).
Participants must have a diagnosis of World Health Organization (WHO) Group 1 Pulmonary Hypertension (PH) [pulmonary arterial hypertension (PAH)] in any of the following subtypes:
- Idiopathic
- Heritable
- Drug/toxin-induced or connective tissue disease (CTD)-associated PAH
- Congenital heart disease-related with simple systemic-to-pulmonary shunt at least 1 year following repair.
- PAH diagnosis for at least 3 months.
Participants must be on stable PH therapy consisting of up to 2 medications from the following classes:
- Endothelin receptor antagonists (eg, ambrisentan, bosentan, macitentan)
- Phosphoesterase type 5 inhibitors (eg, sildenafil, tadalafil)
- Guanylate cyclase stimulator (eg, riociguat)
- No change in PH medications (eg, ambrisentan, bosentan, macitentan, sildenafil, tadalafil, riociguat) or dosage for at least 30 days prior to Screening.
- No change in long-term diuretic use or dosage for at least 30 days prior to Screening.
- Body Mass Index (BMI) within the range 18.0-37.0 kg/m^2 (inclusive).
- Male participants: Male participants who are not sterile and have female partners of childbearing potential, must be using effective contraception from Day 1 to at least 90 days after the last dose of study drug.
- Female participants: Women must be postmenopausal (defined as no menses for 12 months without an alternative medical cause), surgically sterile, (ie, post-tubal ligation for at least 12 months) or using highly effective contraception methods (ie, methods that alone or in combination achieve <1% unintended pregnancy rates per year when used consistently and correctly) from Day 1 to at least 90 days after the last dose of study drug.
- Male participants with pregnant or non-pregnant woman of childbearing potential partner must use a condom in order to avoid potential exposure to embryo/fetus.
- Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the ICF and in the protocol.
Exclusion Criteria:
- History of PH other than idiopathic, hereditary, drug/toxin-induced, repaired simple congenital heart disease, or CTD-associated PAH (eg, complex, congenital heart disease-associated PAH, portal hypertension-associated PAH, PH belonging to Groups 2 through 5).
- Allergy, or documented hypersensitivity or contraindication, to TPIP or Treprostinil or mannitol (an excipient of the TPIP formulation).
- Any known ventricular or supraventricular tachyarrhythmia except for paroxysmal atrial fibrillation and any symptomatic bradycardia.
- History of heart disease including left ventricular ejection fraction (LVEF) ≤ 40% or clinically significant valvular, constrictive, or symptomatic atherosclerotic heart disease (eg, stable angina, myocardial infarction, etc).
- Participation in a cardio-pulmonary rehabilitation program within 1 month of Screening Visit.
- Evidence of thromboembolic disease as assessed by ventilation-perfusion (VQ) scan, pulmonary angiography, or pulmonary computed tomography (CT) scan.
- Active liver disease or hepatic dysfunction.
- History of HIV infection.
- Established diagnosis of hepatitis B viral infection, or positive for hepatitis B surface antigen (HBsAg) at the time of Screening.
- Established diagnosis of hepatitis C viral infection at the time of screening.
- Active and current symptomatic coronavirus disease 2019 (COVID-19) or previous severe disease and/or hospitalization due to COVID-19.
- Use of live attenuated vaccines within 30 days of the Screening Visit.
- Participants with Down's Syndrome.
- History of abnormal bleeding or bruising.
- History of solid organ transplantation.
- Known or suspected immunodeficiency disorder, including history of invasive opportunistic infections (eg, tuberculosis, histoplasmosis, listeriosis, coccidioidomycosis, pneumocystosis, aspergillosis) despite infection resolution, or otherwise recurrent infections of abnormal frequency, or prolonged infections suggesting an immune compromised status, as judged by the Investigator.
- History of alcohol or drug abuse within 6 months prior to Screening.
- Acute or chronic impairment (other than dyspnea), limiting the ability to comply with study requirements, in particular with 6-minute walk test (eg, angina pectoris, claudication, musculoskeletal disorder, need for walking aids).
- Participants with current or recent (past 30 days) lower respiratory tract infection.
- History of malignancy in the past 5 years, with exception of completely treated in situ carcinoma of the cervix and completely treated non-metastatic squamous or basal cell carcinoma of the skin.
- Change in PH medication (endothelin receptor agonists, phosphoesterase type 5 inhibitors, and guanylate cyclase stimulators or diuretics) between Screening and Baseline.
- Have participated in any other interventional clinical studies within 30 days prior to Screening.
- Current use of cigarettes (as defined by Centers for Disease Control and Prevention) or e-cigarettes.
- Participants who currently inhale marijuana (recreational or medical).
- Pregnant or breastfeeding.
Note: Other inclusion/exclusion criteria may apply.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: Treprostinil Palmitil Inhalation Powder
Participants will be administered TPIP once per day at a starting dose of 80 micrograms (μg).
Participants will be up-titrated to the highest tolerated dose for each individual participant of between 80 μg and 640 μg during the initial 3 weeks of treatment.
The overall treatment period will be 16 weeks.
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Administered by oral inhalation using a Plastiape capsule-based dry powder inhaler.
Other Names:
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Placebo Comparator: Placebo
Participants will be administered a placebo matching TPIP once per day for 16 weeks.
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Administered by oral inhalation using a Plastiape capsule-based dry powder inhaler.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Change from Baseline in Pulmonary Vascular Resistance at Week 16
Time Frame: Baseline to Week 16
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Baseline to Week 16
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Change from Baseline in 6-Minute Walk Test Distance at Week 5, Week 10 and Week 16
Time Frame: Baseline and Week 5, Week 10 and Week 16
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Baseline and Week 5, Week 10 and Week 16
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Percent Change from Baseline in 6-Minute Walk Test Distance at Week 5, Week 10 and Week 16
Time Frame: Baseline and Week 5, Week 10 and Week 16
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Baseline and Week 5, Week 10 and Week 16
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Number of Participants Who Experience a Treatment-emergent Adverse Event (AE)
Time Frame: Day 1 up to Week 20
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Day 1 up to Week 20
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Number of Participants Who Experience a Clinically Significant Change from Baseline in Clinical Laboratory Evaluations
Time Frame: Baseline to Week 16
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Baseline to Week 16
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Number of Participants Who Experience a Clinically Significant Change from Baseline in Vital Sign Measurements
Time Frame: Baseline to Week 16
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Baseline to Week 16
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Number of Participants Who Experience a Clinically Significant Change from Baseline in Electrocardiogram (ECG) Measurements
Time Frame: Baseline to Week 16
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Baseline to Week 16
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Number of Participants Who Experience a Clinically Significant Change from Baseline in Physical Examinations
Time Frame: Baseline to Week 16
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Baseline to Week 16
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Change from Baseline in the Concentration of N-Terminal-Pro Hormone Brain Natriuretic Peptide (NT-proBNP) Levels at Week 5, Week 10 and Week 16
Time Frame: Baseline and Week 5, Week 10 and Week 16 or end of study
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Baseline and Week 5, Week 10 and Week 16 or end of study
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Maximum Plasma Concentration (Cmax) of Treprostinil Palmitil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Maximum Plasma Concentration (Cmax) of Treprostinil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Time to Maximum Plasma Concentration (Tmax) of Treprostinil Palmitil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Time to Maximum Plasma Concentration (Tmax) of Treprostinil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Area Under the Concentration-time Curve from Time 0 to 24 Hours Post-Dose (AUC24) of Treprostinil Palmitil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Area Under the Concentration-time Curve from Time 0 to 24 Hours Post-Dose (AUC24) of Treprostinil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Area Under the Concentration-time Curve from Time 0 to Infinity (AUC∞) of Treprostinil Palmitil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Area Under the Concentration-time Curve from Time 0 to Infinity (AUC∞) of Treprostinil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Area Under the Concentration-time Curve from Time 0 to Last Measurable Concentration (AUClast) of Treprostinil Palmitil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Area Under the Concentration-time Curve from Time 0 to Last Measurable Concentration (AUClast) of Treprostinil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Apparent Total Clearance (CL/F) of Treprostinil Palmitil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Apparent Total Clearance (CL/F) of Treprostinil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Apparent Volume of Distribution After Non-Intravenous Administration (Vd/F) of Treprostinil Palmitil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Apparent Volume of Distribution After Non-Intravenous Administration (Vd/F) of Treprostinil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Elimination Half-Life (t1/2) of Treprostinil Palmitil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Elimination Half-Life (t1/2) of Treprostinil
Time Frame: Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Day 1, Weeks 2, 3, 5, 10, and 16: Predose and 0.5, 1, 2 ,4 and 6 hours post-dose
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- INS1009-202
- 2021-001528-16 (EudraCT Number)
- 2023-505541-99-00 (Other Identifier: EU CT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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