Long Term Safety and Efficacy of Ralinepag in Pulmonary Arterial Hypertension
|ClinicalTrials.gov Identifier: NCT02279745|
Recruitment Status : Active, not recruiting
First Posted : October 31, 2014
Last Update Posted : April 23, 2019
|Condition or disease||Intervention/treatment||Phase|
|Pulmonary Arterial Hypertension||Drug: Ralinepag||Phase 2|
This study is an open-label extension study to determine the long-term safety and tolerability of APD811 in patients with WHO Group 1 PAH who have completed the Phase 2 Study APD811-003. Patients must have completed Study APD811-003 and met eligibility criteria for Study APD811-007. Additionally, placebo-treated patients who discontinue study drug treatment due to clinical worsening in Study APD811-003 will be permitted to enroll in Study APD811-007, upon approval of the medical monitor, provided that all end of study procedures including right heart catheterization are performed per protocol. The Week 25 Visit in Study APD811-003 will serve as the Baseline Visit for Study APD811-007.
All patients enrolled in Study APD811-007 will receive open-label treatment with APD811. The starting dose and titration schedule will be individually determined and in accordance with the starting dose and titration schedule optimized from Study APD811-003. Adjustments in the dose and titration schedule may be made according to patient tolerability.
After an individual patient completes Study APD811-003 and that patient's database is locked, patient unblinding will occur. Patients on active treatment (APD811) will remain on current dose and have onsite clinical assessments performed every 3 months until the patient is discontinued from the study.
Patients in the placebo treatment group will undergo a dose titration period until a stable, maximum tolerated dose (MTD) is reached (up to 9 weeks), followed by a treatment period after the MTD is determined during which monthly onsite clinic assessments will be performed for the first 3 months and then every 3 months until the patient is discontinued from the study or the study is terminated (see Table 2).
Discontinuation of the study may also occur at Sponsor's decision to terminate the study. Dose reductions may be made at any time for safety reasons.
Incremental dose increases will also be allowed during the Treatment Period at the discretion of the investigator (as clinically indicated) and according to the stepwise titration scheme. Uptitration should not occur within 6 weeks of an efficacy assessment.
Patients will be assessed for clinical worsening during each clinic visit. If clinical worsening is confirmed, the Investigator may opt to either continue treatment with APD811 at the current dose, increase the dose of APD811, interrupt treatment, or discontinue the patient at his/her discretion.
In addition, all patients will be contacted yearly following discontinuation in Study APD811-007 to assess mortality status. The mortality status follow-up contact of patients who withdraw consent will depend on local regulations or specific agreement with the subject and investigator.
After the last patient enrolled in Study APD811-007 has completed approximately 6 months of the study, a cumulative all-patient data analysis will be performed for all patients who entered the study. Patients will continue to have visits to the clinic every 3 months indefinitely to collect data until marketing approval of APD811 is granted or until the Sponsor discontinues the study. At the time of marketing approval or the Sponsor's decision to discontinue the study, all on-going patients will complete an End of Study Visit. A 28-day Follow-up Visit will be conducted to ensure appropriate subject safety.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||60 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||An Open-Label Extension Study of Ralinepag in Patients With Pulmonary Arterial Hypertension|
|Study Start Date :||July 2015|
|Estimated Primary Completion Date :||September 2019|
|Estimated Study Completion Date :||September 2019|
Ralinepag immediate release (IR) capsules of 0.01, 0.02, 0.03, 0.04 mg, and 0.10 mg per capsule or extended release (XR) tablets of 50, 250, and 400 mcg (0.05, 0.25 and 0.4 mg) for oral administration. The starting dose and titration schedule will be determined for each subject in accordance with the starting dose and titration schedule optimized from Study APD811-003.
Other Name: APD811
- Long-term safety assessed by adverse events up to 28 days following discontinuation of study drug [ Time Frame: From Baseline to 28 days following discontinuation of study drug. ]The number of adverse events will be computed overall and by treatment group in the parent study (Study APD811-003)
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02279745
|United States, Maryland|
|University of Maryland|
|Baltimore, Maryland, United States, 21201|
|United States, Massachusetts|
|Boston University Medical Center|
|Boston, Massachusetts, United States, 02118|
|United States, Ohio|
|Ohio State University Medical Center|
|Columbus, Ohio, United States, 43221|
|United States, Texas|
|University of Texas, Southwestern|
|Dallas, Texas, United States, 75390|
|St Vincent's Hospital|
|Fitzroy, Australia, 3065|
|Fiona Stanley Hospital|
|Murdoch, Australia, 6150|
|Multiprofile Hospital for Active Treatment " St. Anna", Sofia AD, Cardiology Clinic|
|Sofia, Bulgaria, 1750|
|Department of Internal Medicine I - Cardiology, University Hospital Olomouc|
|Olomouc, Czechia, 77900|
|Second Internal Clinic - Clinic of Cardiology and Angiology, 1st Faculty of Medicine, Charles University in Prague, General University Hospital in Prague|
|Prague, Czechia, 12808|
|University of Pecs, Medical School, Heart Institute|
|Pécs, Hungary, 7624|
|Medical University of Bialystok Clinical Hospital|
|Białystok, Poland, 15-276|
|"Marius Nasta" Institute of Pneumoftiziology, Department of Pneumoftiziology IV|
|Bucharest, Romania, 050159|
|"Dr. Victor Babes" Clinic Hospital for Infesctious Diseases and Pneumoftiziology, Department of Clinic Pneumology II|
|Timisoara, Romania, 300310|
|Clinical Centre of Serbia (CCS), Cardiology Clinic|
|Belgrade, Serbia, 11000|
|Clinical Hospital Centre (CHC) Zemun, Clinic for Internal Medicine, Cardiology Department|
|Belgrade, Serbia, 11080|
|Institute of Pulmonary Diseases of Vojvodina Sremska Kamenica (IPDVSK), The Clinic for Urgent Pulmonology, ICU - Intensive Care Unit|
|Sremska Kamenica, Serbia, 21204|
|Clinic Hospital of Barcelona, Department of Pneumology|
|Barcelona, Spain, 11000|
|Hospital 12th of October, Department of Cardiology|
|Madrid, Spain, 28041|
|Study Director:||Isil Saib, MPH||United Therapeutics|