Safety Study of UT-15C SR (Oral Treprostinil) in Patients Undergoing a Lower Limb Endovascular Procedure

This study has been completed.
Sponsor:
Collaborator:
United Therapeutics
Information provided by:
Ochsner Health System
ClinicalTrials.gov Identifier:
NCT00651885
First received: March 31, 2008
Last updated: May 13, 2011
Last verified: March 2008
  Purpose

In chronic CLI patients who are appropriate candidates for endovascular procedures - and many patients are not because of their advanced age and disease state - the treatment regimen may include endovascular procedures such as percutaneous transluminal endovascular intervention, as well as reconstructive surgical procedures such as grafts or bypasses. Amputation is a last resort where limb salvage cannot be achieved. Despite the success of percutaneous intervention for small coronary vessels with lumen diameters less than 3 mm, similar techniques have had limited success in the lower extremity vessels. Infra-popliteal, or below the knee endovascular intervention, is commonly plagued by subacute thrombotic closure and restenosis in as many as 50% of treated patients. As a result of the limited success, these percutaneous procedures have been reserved for the severest cases whereby limb loss is imminent without intervention. In this context, the sickest of all patients are enrolled in these trials and poor outcomes are common regardless of the intervention. Agents that promote intracellular cAMP accumulation, including prostacyclin analogues and phosphodiesterase inhibitors, suppress smooth muscle proliferation, promote vasodilatation and inhibit platelet aggregation. These properties suggest that prostacyclin analogues such as treprostinil will be useful adjuncts to peripheral endovascular intervention and perhaps increase the number of patients with CLI that can benefit from peripheral endovascular intervention. An orally available prostacyclin analogue could represent an important treatment advance in the prevention of restenosis following infrapopliteal angioplasty. In the present study, the safety and efficacy of oral UT-15C sustained release (SR) tablets will be compared to placebo in patients with CLI undergoing an infra-popliteal endovascular intervention.


Condition Intervention Phase
Critical Limb Ischemia
Drug: treprostinil dienthanolmine sustained release
Drug: Placebo
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Single-Center, Placebo Controlled Study To Assess the Safety of UT-15C (Treprostinil Diethanolamine) Sustained Release (SR) in Patients Undergoing an Infra-Popliteal Endovascular Intervention for the Treatment of Critical Limb Ischemia

Resource links provided by NLM:


Further study details as provided by Ochsner Health System:

Primary Outcome Measures:
  • To assess the tolerability and safety of UT-15C SR as compared to placebo tablets in subjects with critical limb ischemia (CLI) undergoing an infra-popliteal endovascular intervention procedure. [ Time Frame: 12 weeks ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To assess the efficacy of UT-15C SR as compared to placebo tablets on measures of clinical outcomes in subjects with critical limb ischemia (CLI) undergoing an infra-popliteal endovascular intervention procedure. [ Time Frame: 12-52 weeks ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 20
Study Start Date: March 2008
Study Completion Date: December 2010
Primary Completion Date: December 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: 2 arm Drug: Placebo
Placebo
Experimental: 1 arm
treprostinil dienthalomine
Drug: treprostinil dienthanolmine sustained release
UT-15C SR 1mg tablet
Other Name: UT-15C SR

Detailed Description:

This study is a randomized, placebo controlled, single-center, evaluation of the safety and efficacy of UT-15C SR compared to placebo in patients with CLI with a planned infra-popliteal endovascular intervention procedure. Conventional therapy should be continued for all patients in the study. Conventional therapy is defined as the customary best medical practice at this investigative site for CLI, including analgesics for rest pain, debridement and wound care for ischemic wounds, etc., as long as such care meets the other requirements of the study and does not include prohibited therapies or investigational medications. A total of 20 patients will be prospectively randomized (1:1) to conventional treatment and placebo therapy in conjunction with an endovascular procedure or conventional treatment and UT-15C SR therapy in conjunction with an infrapopliteal endovascular procedure. Treatment is UT-15C sustained release (SR) tablets (1.0 mg dosage strength) or placebo. Treatment will be initiated at 1 mg twice daily with dose escalation of an additional 1 mg twice daily every 5 days if clinically indicated based upon the presence of known prostacyclin adverse events or adverse events that in the opinion of the investigator are attributable to UT-15C SR. Doses should be maximized throughout the Treatment Phase up to a maximum dose of 5 mg twice daily at the end of 12-weeks. Patients will return to the institution for the endovascular procedure at least 4 days after starting study drug and continue study drug, throughout the endovascular procedure and to Week 12. All patients will return to the clinic at Weeks 2, 6 and 12 for Treatment Phase assessments, and then Weeks 26 and 52 for follow-up assessments.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Be 18 or older.
  2. Have an anticipated infra-popliteal endovascular intervention.
  3. Have a diagnosis of stage IIb- IVa (Fontaine) or stage 3- 5 (Rutherford scale) CLI due to documented peripheral arterial disease (Appendix E)
  4. If female, be physiologically incapable of childbearing or practicing acceptable methods of birth control.
  5. Have signed an appropriate informed consent for participation in this study.

Exclusion Criteria:

  1. Have had a previous endovascular intervention or stenting on the target limb.
  2. Be hemodynamically unstable, on hemodialysis for end stage renal failure, or have acute renal, cardiac or pulmonary failure.
  3. Have a history of intracranial bleeding, bleeding ulcer, urinary tract bleeding; or bleeding due to significant trauma within six weeks prior to study entry.
  4. Have a life-threatening malignancy requiring aggressive chemotherapy.
  5. Have any condition or laboratory value which, based on information in the UT-15C SR investigators' brochure, would constitute an unacceptable risk to the patient's safety, in the opinion of the investigator.
  6. Have unstable psychiatric status or be mentally incapable of understanding the objectives, nature or consequences of the trial.
  7. Have a known hypersensitivity to prostacyclin.
  8. Have participated in any investigational trial within 30 days of study drug initiation.
  9. Have been a non-responder to chronic (>30 days) prostanoid treatment, or have completed a chronic trial of prostanoid therapy within 30 days of study drug initiation.
  10. Be a pregnant or nursing woman.

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  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00651885

Locations
United States, Louisiana
Ochsner Clinic Foundation
New Orleans, Louisiana, United States, 70121
Sponsors and Collaborators
Ochsner Health System
United Therapeutics
Investigators
Principal Investigator: Mark A Grise, M.D. Ochsner Clinic Foundation
  More Information

No publications provided

Responsible Party: Mark Grise. M.D., Ochsner Clinic Foundation
ClinicalTrials.gov Identifier: NCT00651885     History of Changes
Other Study ID Numbers: 2006.219.B
Study First Received: March 31, 2008
Last Updated: May 13, 2011
Health Authority: United States: Food and Drug Administration

Keywords provided by Ochsner Health System:
UT-15C
Peripheral Vascular Disease
Treprostinil

Additional relevant MeSH terms:
Ischemia
Pathologic Processes
Treprostinil
Antihypertensive Agents
Cardiovascular Agents
Therapeutic Uses
Pharmacologic Actions

ClinicalTrials.gov processed this record on July 28, 2014