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A Phase 2 Study to Determine the Safety and Efficacy of AIR001 in Subjects With Pulmonary Arterial Hypertension (PAH)

7 avril 2014 mis à jour par: Aires Pharmaceuticals, Inc.

A Phase 2, Multi-Center, Open-label, Randomized, Parallel-Dose Study to Determine the Safety and Efficacy of AIR001 in Subjects With WHO Group 1 Pulmonary Arterial Hypertension (PAH)

The purpose of this study is to evaluate the safety and effectiveness of an investigational/experimental drug called AIR001.

To test the effectiveness, the study will evaluate how AIR001 affects the blood vessels in the lungs and the function of the heart. This will be done by monitoring changes in Pulmonary Vascular Resistance (PVR); from Baseline/Day 1 (start of study drug) to Week 16 of the study. PVR measures the resistance to flow in the blood vessels of the lungs. The study will include other assessments to evaluate the effect of the study drug on PAH, including measurements of exercise ability and evaluations of PAH disease symptoms.

Aperçu de l'étude

Description détaillée

The primary objective of this study is to evaluate the efficacy of inhaled nebulized AIR001 administered, for 16 weeks, according to 3 treatment arms (80 mg once daily, 46 mg 4 times daily, or 80 mg 4 times daily) in subjects with World Health Organization (WHO) Group 1 Pulmonary Arterial Hypertension (PAH), as determined by change in Pulmonary Vascular Resistance (PVR) from Baseline to Week 16 measured immediately post completion of AIR001 nebulization (as soon as feasible).

Type d'étude

Interventionnel

Inscription (Réel)

29

Phase

  • Phase 2

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • New South Wales
      • Darlinghurst, New South Wales, Australie, 2010
        • St. Vincent's Hospital
    • Queensland
      • Chermside, Queensland, Australie, 4032
        • The Prince Charles Hospital
    • Tasmania
      • Hobart, Tasmania, Australie, 7000
        • Royal Hobart Hospital
    • Victoria
      • Melbourne, Victoria, Australie, 3004
        • The Alfred Hospital
      • Budapest, Hongrie, 1083
        • Gottsegen Gyorgy Hungarian
      • Budapest, Hongrie, 1125
        • Semmelweis Karlocai
      • Debrecen, Hongrie, 4032
        • University of Debrecen
      • Szeged, Hongrie, 6720
        • University Of Szeged
    • California
      • La Jolla, California, États-Unis, 92037
        • UCSD Medical Center
      • Torrance, California, États-Unis, 90509
        • UCLA Medical Center
    • Colorado
      • Aurora, Colorado, États-Unis, 80045
        • University of Colorado Denver
    • Kentucky
      • Louisville, Kentucky, États-Unis, 40202
        • Kentuckiana Pulmonary Associates
    • Maryland
      • Baltimore, Maryland, États-Unis, 21201
        • University of Maryland Medical Center
    • Massachusetts
      • Boston, Massachusetts, États-Unis, 02115
        • Brigham and Women's Hospital
      • Boston, Massachusetts, États-Unis, 02111
        • Tufts Medical Center
      • Boston, Massachusetts, États-Unis, 02118
        • Boston University School of Medicine
    • Missouri
      • St. Louis, Missouri, États-Unis, 63110-1093
        • Washington University School of Medicine
    • North Carolina
      • Durham, North Carolina, États-Unis, 27710
        • Duke University Medical Center
    • Ohio
      • Cincinnati, Ohio, États-Unis, 45267
        • University of Cincinnati
      • Columbus, Ohio, États-Unis, 43210
        • The Ohio State University Medical Center
    • Pennsylvania
      • Pittsburgh, Pennsylvania, États-Unis, 15213
        • University of Pittsburgh Medical Center
    • Texas
      • Dallas, Texas, États-Unis, 75390
        • University of Texas Southwestern Medical Center
      • Houston, Texas, États-Unis, 77030
        • Baylor College of Medicine
    • Virginia
      • Falls Church, Virginia, États-Unis, 22042
        • INOVA Fairfax Hospital
    • Wisconsin
      • Milwaukee, Wisconsin, États-Unis, 53215
        • Aurora St. Luke's Medical Center

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans à 75 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Signed and dated informed consent document
  2. Able to comply with study procedures
  3. Diagnosis of PAH as classified by:

    1. Idiopathic (IPAH) or heritable(HPAH); or
    2. PAH associated with CTD; Systemic Sclerosis, Limited Scleroderma, Mixed, SLE, or overlap syndrome;
    3. PAH associated with HIV ii. Simple, congenital shunts at least one year post repair. iii. Exposure to legal drugs, chemicals and toxins
  4. Cardiac catheterization prior to Screening with:

    1. mPAP ≥ 25 mmHg (at rest);
    2. PCWP ≤ 15 mmHg; and
    3. PVR > 3 mmHg/L/min or 240 dyn.sec/cm5
  5. A qualification cardiac catheterization, to confirm the persistence and severity of PAH, if the diagnostic catheterization was performed more than 30 days prior to Baseline

    1. Confirms diagnosis;
    2. PVR above 300 dyn.sec/cm5 to demonstrate the persistence and severity of PAH; and
    3. No change in disease-specific PAH therapy since the qualification catheterization used
  6. Newly diagnosed PAH on no disease-specific PAH therapy or previously diagnosed on oral disease-specific PAH therapy for 90 days prior with either an ETRA and/or PDE-5i
  7. Has PFTs within 180 days prior to Baseline with no evidence of significant parenchymal lung disease defined as:

    • FEV1 ≤ 70% (predicted) (pre-bronchodilators);
    • FEV1/FVC ≤ 70% (pre-bronchodilators); or
    • Total lung capacity < 70% (predicted).
  8. Has WHO/NYHA FC II- IV.
  9. ≥ 18 and ≤ 75 years.
  10. Weight ≥ 40 kg.
  11. Has 6MWT distance at least 50 meters.
  12. Had a V/Q scan or pulmonary angiogram prior to Screening that shows no evidence of thromboembolic disease
  13. If on the following: vasodilators (including calcium channel blockers), digoxin, spironolactone, or L-Arginine; must be on a stable dose 30 days prior to Baseline and maintained throughout the study
  14. If on corticosteroids, has been receiving a stable dose of ≤ 20 mg/day of prednisone (or equivalent dose, if other corticosteroid) for at least 30 days
  15. Women of childbearing potential must be using at least one form of medically acceptable contraception. Women who are surgically sterile or those who are post-menopausal for at least 2 years are not considered to be of childbearing potential. Men who are not sterile must also agree to use contraception

Exclusion Criteria:

  1. Participation in a device or other interventional clinical studies, within 30 days of Baseline and during study participation
  2. Participation in a cardio-pulmonary rehabilitation program based upon exercise within 30 days prior to Baseline and/or during the study
  3. Has uncontrolled systemic hypertension: SBP > 160 millimeter of mercury (mmHg) or DBP > 100 mmHg during Screening
  4. SBP < 90 mmHg at Screening or Baseline
  5. History of orthostatic hypotension or at the time of Screening; defined as a drop in SBP by ≥ 20 mmHg or DBP of ≥ 10 mmHg during Screening
  6. History of left-sided heart disease and/or clinically significant cardiac disease, including:

    1. Aortic or mitral valve disease (stenosis or regurgitation) defined as greater than mild;
    2. Pericardial constriction;
    3. Restrictive or congestive cardiomyopathy;
    4. Left ventricular ejection fraction < 40%
    5. Left ventricular shortening fraction < 22% by ECHO prior to Screening;
    6. Symptomatic coronary disease
  7. Significant (2+ for regurgitation) valvular disease other than TR or PR
  8. Acutely decompensated heart failure within 30 days prior to Baseline
  9. History of atrial septostomy within 180 days prior to Baseline
  10. History of obstructive sleep apnea (treated, untreated or resolved)
  11. Diagnosis of Down syndrome
  12. Moderate to severe hepatic impairment
  13. Has chronic renal insufficiency as defined by serum creatinine > 2.5 mg/dL or has an eGFR < 30 mL/min at Screening, or requires dialysis
  14. Has a Hgb concentration < 8.5 g/dL at Screening
  15. Personal or family history of the following:

    1. Congenital or acquired methemoglobinemia;
    2. RBC CYPB5 reductase deficiency
  16. G6PD deficiency or any contraindication to receiving methylene blue
  17. For subjects with HIV any of the following:

    • Concomitant active opportunistic infections 180 days prior to Screening;
    • Detectable viral load within 90 days of Screening;
    • T-cell count < 200 mm3 within 90 days of Screening;
    • Changes in antiretroviral regimen within 90 days of Screening;
    • Using inhaled pentamidine
  18. Receiving chronic treatment with prostacyclin/prostacyclin analogue within 60 days of Baseline
  19. Requirement of intravenous inotropes within 30 days prior to Baseline
  20. The use of oral or topical nitrates (nitroglycerin, glyceryl trinitrate (GTN), isosorbide dinitrate, and isosorbide mononitrate) within 30 days prior to Baseline and until EOS or Termination
  21. Known or suspected hypersensitivity or allergic reaction to sodium nitrite or sodium nitrate
  22. History of malignancy within 5-years prior to Baseline
  23. Other severe acute or chronic medical or laboratory abnormality that may increase the risk associated with study participation
  24. Has a disorder that compromises the ability to give informed consent
  25. Is currently pregnant or breastfeeding or intends to become pregnant
  26. Investigators, study staff or their immediate families

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: 80mg AIR001 four times daily
80mg AIR001 nebulized four times daily for 16 weeks
Dose arms specify dose loaded into the I-neb AAD System nebulizer
Autres noms:
  • nitrite de sodium
  • nitrite
  • sodium nitrite inhalation solution
Expérimental: 46mg AIR001 four times daily
46mg AIR001 nebulized four times daily for 16 weeks
Dose arms specify dose loaded into the I-neb AAD System nebulizer
Autres noms:
  • nitrite de sodium
  • nitrite
  • sodium nitrite inhalation solution
Expérimental: 80mg AIR001 once daily
80mg AIR001 nebulized once daily for 16 weeks
Dose arms specify dose loaded into the I-neb AAD System nebulizer
Autres noms:
  • nitrite de sodium
  • nitrite
  • sodium nitrite inhalation solution

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change in pulmonary vascular resistance (PVR)from baseline to week 16 assessed at peak AIR001
Délai: 16 weeks
The primary objective of this study is to evaluate the efficacy of inhaled nebulized AIR001 administered, for 16 weeks, according to 3 treatment arms (80 mg once daily, 46 mg 4 times daily, or 80 mg 4 times daily) in subjects with World Health Organization (WHO) Group 1 Pulmonary Arterial Hypertension (PAH), as determined by change in Pulmonary Vascular Resistance (PVR) from Baseline to Week 16 measured immediately post completion of AIR001 nebulization (as soon as feasible).
16 weeks

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Time to Clinical Worsening (TTCW), other hemodynamics, and safety
Délai: 16 weeks

To evaluate the effect of inhaled nebulized AIR001 administered according to 3 treatment arms (80 mg once daily, 46 mg 4 times daily, or 80 mg 4 times daily) in subjects with WHO Group 1 PAH for 16 weeks, as determined by time to the first morbidity/mortality event as defined in Time to Clinical Worsening (TTCW) assessments and change from Baseline to Week 16 in the following:

Pulmonary Vascular Resistance Index (PVRI), N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP), 6-Minute Walk Distance (6MWD) assessed at peak, 6MWD assessed prior to AIR001 nebulization (trough), Cardiac Output (CO), Cardiac Index (CI), Mean Right Atrial Pressure (mRAP), WHO/NYHA Functional Class (FC), Quality of Life (QOL) as measured by Short-Form 36 (SF-36), Borg Dyspnea Index, Mean pulmonary artery pressure (mPAP), PVR measured at trough, PVR/systemic vascular resistance (SVR) ratio at trough and peak,

To evaluate the safety and tolerability of AIR001 in subjects with WHO Group 1 PAH.

16 weeks

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: Adaani E Frost, M.D., Baylor College of Medicine

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 novembre 2012

Achèvement primaire (Réel)

1 février 2014

Achèvement de l'étude (Réel)

1 février 2014

Dates d'inscription aux études

Première soumission

8 novembre 2012

Première soumission répondant aux critères de contrôle qualité

9 novembre 2012

Première publication (Estimation)

12 novembre 2012

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

9 avril 2014

Dernière mise à jour soumise répondant aux critères de contrôle qualité

7 avril 2014

Dernière vérification

1 avril 2014

Plus d'information

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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