Effects of Bosentan (Tracleer) in the Course of Pulmonary Artery Hypertension Induced by Hypoxia

Excessive rise in pulmonary artery pressure induced by low oxygen tension (hypoxia) is one of the factors implicated in high-altitude pulmonary oedema. Plasma ET1 increases in subjects exposed to high altitude and is correlated to pulmonary artery pressure.

The aim of the study is to investigate whether blockade of ET1 receptors would reduce the acute rise in systolic pulmonary artery pressure induced by hypoxia.

Study Overview

• Status: Completed
• Conditions: Hypoxia-Induced Pulmonary Artery Hypertension
• Intervention / Treatment: Drug: Bosentan; Drug: Bosentam TRACLEER

Detailed Description

Patients will be examined on a variable load supine bicycle ergometer. The exercise table will be tilted laterally by 20 to 30 degrees to the left. PASP will be assessed using Doppler echocardiography at rest and during during supine bicycle exercise in NORMOXIA and hypoxia. Exposure to normobaric hypoxia will be performed by breathing a hypoxic gas mixture at sea level during 90 minutes (12,3 % O2 + 87.7 % N2) reproducing conditions at 4300 m altitude. Exercise will be started at an initial workload of 40 watts and increased by 10 watts every minute to reach a workload level defined by a heart rate (HR) corresponding to 50% of the estimated maximal aerobic power

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Phase 1

Contacts and Locations

Study Locations

• France
  • Paris, France, 75908 Cedex 15
    • Centre d'Investigation Clinique 9201 Hôpital Européen Georges Pompidou

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• 20 non smoker healthy volunteers : 10 resistant to high-altitude pulmonary oedema and 10 susceptible subjects, without history of cardiac or pulmonary disease or asthma, after a complete clinical examination and safety laboratory measurements prior to randomization, and after giving informed written consent.

Exclusion Criteria:

• antecedent of lung disease notably with asthmatic antecedent or HTAP
• antecedent of heart disease
• female genital organ
• systolic blood pressure < 85 mmHg or > 160 mmHg after 5 minutes of lengthened rest.
• sentimentality in a medicine, in particular in a bosentan or in one of the excipients of the tablet.
• hepatic incapacity moderated to severe correspondent in the class B or C of the classification of Child-Pugh (cf Pharmacokinetics) Rate serous hepatic aminotransferases, aspartate aminotransferases( ASAT) and\or alanine aminotransférases ( ALAT), superior to 3 times the superior limit of the normal before the started of the treatment.
• pointed or chronic systematic diseases.
• presence of antibody anti-HIV, of anti-HVC antibody, antigens Hbs and\or antibody anti-Hbc. - active addiction to smoking.
• alcohol abuse and of toxins.
• Taking of concomitant medicines except those allowed the chapter concomitant treatments.
• signs, symptoms or values of the biological examinations situated except the clinically acceptable values for healthy subjects with or without antecedent of OPHA.
• common(current) ingestion of excessive quantities of tea, coffee(cafe), chocolate and\or drinks containing some caffeine (> 5 cups / day, is approximately 500 mg of caffeine a day).
• consumption of juice of grapefruit and\or herb tea on base of St.
• John's wort
• Don of blood in 3 months preceding the study.
• Persons in period of exclusion on the national file of the persons lending itself to the biomedical search(research) without direct individual profit.
• refusal or linguistic or psychic incapacity to sign the lit(enlightened) assent.
• subject which can not submit itself to the constraints of the protocol (for example, not cooperative, incapable to go(surrender) to the visits of follow-up and probably incapable to finish the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1; Experimental and Placebo Comparator administered in random order during to successive experimental phase	Drug: Bosentan; Single dose administration of 250 mg bosentan (2 pills Tracleer 125 mg) or placebo; Other Names: TRACLEER
Placebo Comparator: 2; Experimental and Placebo Comparator administered in random order during to successive experimental phase	Drug: Bosentam TRACLEER; Single dose administration of 250 mg bosentan (2 pills Tracleer 125 mg) or placebo

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
To investigate whether bosentan compared to placebo reduces hypoxia-induced increase in pulmonary artery pressure in healthy subjects and in subjects with past history of high-altitude pulmonary oedema	during the study

Secondary Outcome Measures

Outcome Measure	Time Frame
To compare	during the study
pulmonary artery pressure response to exercise,	during the study
exercise capacity,	during the study
oxygen desaturation,	during the study
and to assess the global safety	during the study

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris
• Investigators: Principal Investigator: Michel AZIZI, MD,PhD, Assistance Publique - Hôpitaux de Paris

Publications and helpful links

General Publications

• Grunig E, Mereles D, Hildebrandt W, Swenson ER, Kubler W, Kuecherer H, Bartsch P. Stress Doppler echocardiography for identification of susceptibility to high altitude pulmonary edema. J Am Coll Cardiol. 2000 Mar 15;35(4):980-7. doi: 10.1016/s0735-1097(99)00633-6.

Study record dates

Study Major Dates

• Study Start: January 1, 2006
• Primary Completion (Actual): April 1, 2008
• Study Completion (Actual): April 1, 2008

Study Registration Dates

• First Submitted: December 1, 2005
• First Submitted That Met QC Criteria: December 1, 2005
• First Posted (Estimate): December 2, 2005

Study Record Updates

• Last Update Posted (Estimate): October 17, 2008
• Last Update Submitted That Met QC Criteria: October 16, 2008
• Last Verified: March 1, 2007

More Information

Terms related to this study

• Keywords: Hypoxia-induced pulmonary artery hypertension; High-altitude pulmonary oedema; ETA receptor antagonist
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Respiratory Tract Diseases; Lung Diseases; Signs and Symptoms, Respiratory; Hypertension, Pulmonary; Hypertension; Pulmonary Arterial Hypertension; Hypoxia; Molecular Mechanisms of Pharmacological Action; Antihypertensive Agents; Endothelin Receptor Antagonists; Bosentan
• Other Study ID Numbers: P050502; AOR05038