- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT01224210
Ambrisentan in Patients With Porto-pulmonary Hypertension A Multicenter Open Label Trial (Portopulm)
This is an Open Label, Multicenter, pilot clinical trial to assess the efficacy and safety of an oral selective Endothelin Receptor Antagonist (ambrisentan) in patients with portopulmonary hypertension.
Preliminary evidence suggests that ambrisentan is safe and effective in patients with portopulmonary hypertension. The goal of therapy for these patients is to improve symptoms of dyspnea and to improve pulmonary hemodynamics to a mean pulmonary artery pressure <35 mm Hg in order to make patients eligible for liver transplantation. Therefore, the primary endpoints for this study will include 6 minute walk distance (6MWD) and pulmonary vascular resistance (PVR).
Eligible subjects will receive 5 mg ambrisentan once-daily for the first 4 weeks. After the initial 4-week period, investigators will increase study drug dose to 10 mg once daily (both 5 mg and 10 mg doses are FDA approved). If 10 mg is not tolerated in the opinion of investigator, then the investigator may decrease the dose back to 5 mg once daily. Primary outcome is a change in both the 6 Minute Walk Distance and in Pulmonary Vascular Resistance from baseline to Week 24. Subjects will be monitored with liver function tests (LFT) every 2 weeks for the first 8 weeks, then every 4 weeks thereafter. These safety laboratory tests may be performed at a local phlebotomy laboratory or at the Investigator clinic. In addition, the Investigator will assess each subject for safety and efficacy at Week 4, Week 12, and Week 24. Following Week 24, subjects will be assessed for safety and efficacy every 12 weeks. Patients will be followed for a total of 1 year. After 1 year, if the Investigator feels that continuing the treatment will be beneficial to the patients, they will be provided with ambrisentan by Gilead Pharmaceuticals, free of charge.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 3
Kontakter og lokationer
Studiesteder
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California
-
La Jolla, California, Forenede Stater, 92093
- Ucsd Medical Center
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-
Florida
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Jacksonville, Florida, Forenede Stater, 32224
- Mayo Clinic Florida
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Massachusetts
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Boston, Massachusetts, Forenede Stater, 02111
- Tufts Medical Center
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North Carolina
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Chapel Hill, North Carolina, Forenede Stater, 27599
- University of North Carolina
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Ohio
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Columbus, Ohio, Forenede Stater, 43221
- The Ohio State University Medical Center
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Texas
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Dallas, Texas, Forenede Stater, 75390
- UT Southwestern Medical Center
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-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
Subjects need to fulfill all of the following 4 criteria:
- Evidence of portal hypertension (by hemodynamic measurement, or by Doppler flow of portal circulation, or by clinical evidence of portal hypertension such as esophageal or gastric varices, as evidenced by prior upper endoscopy).
Evidence of pulmonary arterial hypertension by right heart catheterization (all three criteria need to be present) Right heart catheterization may have been performed up to 30 days prior to screening
- Mean PAP (pulmonary artery pressure) >25 mm Hg, and
- PVR (pulmonary vascular resistance) >240 dynes/s/cm5, and
- TPG (transpulmonary gradient = meanPAP -PAWP) >12 mm Hg
- Baseline AST, ALT < 5 times the upper limit of normal, total Bili < 3.0 mg/dl, and mild liver impairment with Child -Pugh class A or B
- Ages 18 years and above
Exclusion Criteria:
- Presence of any other etiology of pulmonary arterial hypertension (HIV, connective tissue disease, sickle cell, left heart failure, chronic thromboembolic PH, etc)
- Treatment with prostacyclins, other ERAs, or PDE5 inhibitors within 30 days of enrollment.
- Moribund state or anticipated death within 1 month.
- AST or ALT ≥ 5 times upper limit of normal
- Total bilirubin ≥ 3.0 mg/dl
- Significant lung disease (obstructive lung disease with FEV1 < 1L, or FEV1/FVC <50%; or restrictive lung disease with Total Lung Capacity < 60% predicted). PFTs may have been performed up to 6 months prior to enrollment.
- Pregnancy
- Age <18 years
- Child -Pugh class C
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
---|---|
Andet: Ambrisentan (24 Weeks), Extension (4 Weeks)
Open Label Ambrisentan
|
Ambrisentan once-daily in the morning with or without food.
The adult dose selected for this study will be 5 mg for the first 4 weeks.
After the initial 4 weeks the dose will be increased to 10mg (available doses are 5, and 10 mg) based on tolerance safety.
Subjects will remain on 10mg until they complete the study.
Dose adjustments may be made based on side effects.
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
Change in Pulmonary Vascular Resistance
Tidsramme: from baseline to Week 24
|
Change in Pulmonary Vascular Resistance from baseline to Week 24 for all patients (using cardiac output [CO] measured by the thermodilution method and reported as percent difference from baseline).
|
from baseline to Week 24
|
6 Minute Walk Distance
Tidsramme: Change from baseline to Week 24
|
Change from baseline in 6 Minute Walk Distance to Week 24 for all patients.
(difference measured in meters).
|
Change from baseline to Week 24
|
Samarbejdspartnere og efterforskere
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Ioana Preston, MD, Tufts Medical Center
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- Ambrisentan Portopulm Study
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
produkt fremstillet i og eksporteret fra U.S.A.
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Kliniske forsøg med Portopulmonal hypertension
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BayerAfsluttet
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National Taiwan University Hospital Hsin-Chu BranchRekrutteringHypertension, essentiel | Hypertension, maskeretTaiwan
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Sheffield Teaching Hospitals NHS Foundation TrustUniversity of SheffieldAfsluttetIdiopatisk pulmonal arteriel hypertension | Kronisk tromboembolisk pulmonal hypertensionDet Forenede Kongerige
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Papworth Hospital NHS Foundation TrustMerck Sharp & Dohme LLCAfsluttet
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University of Kansas Medical CenterRekrutteringPulmonal arteriel hypertension | Pulmonal hypertension | Kronisk tromboembolisk pulmonal hypertension | Pulmonal hypertension på grund af venstre hjertesygdom | Pulmonal hypertension, primær, 4 | Pulmonal hypertension, primær, 2 | Pulmonal hypertension, primær, 3 | Pulmonal hypertension, primær | Pulmonal...Forenede Stater
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Centre Chirurgical Marie LannelongueUkendtKronisk trombo-embolisk pulmonal hypertension og pulmonal arteriel hypertensionFrankrig
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University of South FloridaTrukket tilbagePulmonal arteriel hypertension | Familiær primær pulmonal hypertension | Idiopatisk pulmonal arteriel hypertension | Primær pulmonal hypertensionForenede Stater
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Heidelberg UniversityMerck Sharp & Dohme LLCRekrutteringKronisk tromboembolisk pulmonal hypertension | Primær pulmonal arteriel hypertensionTyskland
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Columbia UniversityAgency for Healthcare Research and Quality (AHRQ)Aktiv, ikke rekrutterendeWhite Coat Hypertension | Hypertension, essentielForenede Stater
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Amsterdam UMC, location VUmcZonMw: The Netherlands Organisation for Health Research and DevelopmentUkendt
Kliniske forsøg med Ambrisentan
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GlaxoSmithKlineAfsluttetHypertension, lungeFrankrig, Forenede Stater, Tyskland, Spanien, Italien, Japan, Ungarn, Den Russiske Føderation, Argentina
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Medical University of GrazTrukket tilbage
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Soumya ChatterjeeGilead SciencesAfsluttet
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Gilead SciencesAfsluttetStudy to Assess Safety and Efficacy of Ambrisentan in Subjects With Pulmonary Arterial Hypertension.Pulmonal arteriel hypertension
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Gilead SciencesAfsluttet
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University of Alabama at BirminghamAfsluttetPulmonal arteriel hypertensionForenede Stater
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GlaxoSmithKlineAfsluttet
-
Gilead SciencesAfsluttet
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Bnai Zion Medical CenterRambam Health Care CampusUkendtNyresvigt, akutIsrael
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GlaxoSmithKlineAfsluttetForhøjet blodtrykSpanien, Tyskland, Korea, Republikken, Canada, Japan, Holland, Det Forenede Kongerige, Forenede Stater, Kina, Østrig, Israel, Argentina, Den Russiske Føderation, Mexico, Saudi Arabien, Tjekkiet