Exercise Induced Pulmonary Hypertension in Systemic Sclerosis and Treatment With Ambrisentan

The recruitment status of this study is unknown because the information has not been verified recently.
Verified February 2009 by University of California, Los Angeles.
Recruitment status was  Recruiting
Sponsor:
Collaborator:
Gilead Sciences
Information provided by:
University of California, Los Angeles
ClinicalTrials.gov Identifier:
NCT01051960
First received: January 19, 2010
Last updated: NA
Last verified: February 2009
History: No changes posted
  Purpose

The purpose of this study is to determine the clinical characteristics and hemodynamic profiles that predict exercise induced pulmonary hypertension in 15 patients with systemic sclerosis. The study also aims to determine the effectiveness of Ambrisentan for subjects with exercise induced Pulmonary Arterial Hypertension (PAH) with scleroderma


Condition Intervention Phase
Systemic Sclerosis
Shortness of Breath
Pulmonary Hypertension
Drug: Ambrisentan
Phase 4

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Exercise Induced Pulmonary Hypertension in Systemic Sclerosis and Treatment With Ambrisentan: A Prospective Single Center, Open Label, Pilot Study

Resource links provided by NLM:


Further study details as provided by University of California, Los Angeles:

Primary Outcome Measures:
  • Change in multipoint exercise total pulmonary resistance (TPR)from baseline to week 24. [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Change in distance walked in six minutes from baseline to 24 week [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • SF-36, HAQ-DI, and St. George's respiratory questionnaire total score from baseline to 24 weeks of therapy [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

Estimated Enrollment: 15
Study Start Date: March 2009
Estimated Study Completion Date: December 2010
Estimated Primary Completion Date: June 2010 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: Ambrisentan
    Ambrisentan 5mg or 10mg once daily
    Other Name: Letairis
Detailed Description:

The current literature addresses therapies for patients with resting PAH only, diagnosed by right heart catheterization. However, the World Health Organization (WHO) also recognizes and defines exercise induced pulmonary arterial hypertension (ex-PAH), which may precede the development of resting PAH. The natural progression of PAH, especially during exercise, has not been well delineated. An exercise hemodynamic study previously showed that in normal healthy subjects the mean pulmonary pressure does not exceed 30mmHg even at maximal cardiac outputs. A prior study evaluated exercise Doppler echocardiography systemic sclerosis patients with normal resting echocardiograms, finding an abnormal response which was defined as an estimated right ventricular systolic pressure greater than 40 mmHg. In the same study, 6.6% of the patients progressed to resting PAH over the followup period of 12 months. Limited data is available regarding the prevalence of ex-PAH in systemic sclerosis using right heart catheterization.

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Systemic Sclerosis diagnosed by the American College of Rheumatology consensus statement including any of the following:

    • Limited
    • Diffuse
    • Sine Scleroderma
  2. Patients must be willing and able to undergo right heart catheterization with lower extremity cycle ergometry
  3. Mean pulmonary artery pressure (mPAP) > 30mmHg with exercise; PCWP ≤ 15mmHg on RHC at rest
  4. Men and women, ages 18 years of age or older
  5. Standard adjunctive medications will be allowed concurrently in this study at the discretion of the treating pulmonologist and rheumatologist, including digoxin, diuretics, anticoagulants (e.g. warfarin), stable immunosuppression or other anti-fibrotic therapy for at least one month prior to enrollment

Exclusion Criteria:

  1. Resting PAH (mPAP > 25mmHg) on right heart catheterization
  2. Other known causes of PAH including prior venous thromboembolism, HIV infection, chronic liver disease with portal hypertension, left ventricular systolic dysfunction (e.g. LVEF < 40%), and congenital causes of PAH
  3. Severe hepatic disease precluding the use of ambrisentan (AST/ALT ≥3x ULN).
  4. Women who are pregnant or breastfeeding.
  5. Concurrent therapy with a prostanoid or prostanoid analogue, PDE5 inhibitors, or enrolled in another active clinical study.
  6. Use of any prostacyclin or endothelial receptor antagonist (ERA) within 30 days before study entry.
  7. Bed or wheel chair bound or a baseline 6-Minute Walk distance (6MWD) less than 150 meters.
  8. Childbearing capable women who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period.
  9. New York Heart Association (NYHA) Classification: Class IV
  10. Renal dysfunction (serum creatinine >2.5mg/dL).
  11. Uncontrolled sleep apnea.
  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: NCT01051960

Contacts
Contact: Rajeev Saggar, MD 310-825-5635 rasaggar@mednet.ucla.edu
Contact: Amber Betchel 310-825-0425 ABechtel@mednet.ucla.edu

Locations
United States, California
David Geffen School of Medicine, University of California, Los Angeles Recruiting
Los Angeles, California, United States, 90095
Contact: Amber Betchel    310-825-0425    abetchel@mednet.ucla.edu   
Contact: Rajeev Saggar, MD    310-825-5635    rasaggar@mednet.ucla.edu   
Sub-Investigator: Daniel Furst, MD         
Sub-Investigator: Shelley Shapiro, MD         
Sub-Investigator: Rajan Saggar, MD         
Sub-Investigator: Philip Clements, MD         
Sponsors and Collaborators
University of California, Los Angeles
Gilead Sciences
Investigators
Principal Investigator: Rajeev Saggar, MD University of California, Los Angeles
Principal Investigator: Dinesh Khanna, MD University of California, Los Angeles
  More Information

No publications provided by University of California, Los Angeles

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Rajeev Saggar, MD, David Geffen School of Medicine, University of California, Los Angeles
ClinicalTrials.gov Identifier: NCT01051960     History of Changes
Other Study ID Numbers: 08-05-003
Study First Received: January 19, 2010
Last Updated: January 19, 2010
Health Authority: United States: Food and Drug Administration

Keywords provided by University of California, Los Angeles:
Systemic Sclerosis
connective tissue disease
Shortness of breath
Pulmonary Hypertension

Additional relevant MeSH terms:
Hypertension
Hypertension, Pulmonary
Sclerosis
Scleroderma, Systemic
Scleroderma, Diffuse
Dyspnea
Vascular Diseases
Cardiovascular Diseases
Lung Diseases
Respiratory Tract Diseases
Pathologic Processes
Connective Tissue Diseases
Skin Diseases
Respiration Disorders
Signs and Symptoms, Respiratory
Signs and Symptoms

ClinicalTrials.gov processed this record on September 16, 2014