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COMPASS-1 / Hemodynamic effects of a single dose of sildenafil in symptomatic patients on bosentan treatment for pulmonary arterial hypertension – A multicenter, open-label, non-comparative, prospective, phase II study - COMPASS-1

Conditions
Symptomatic Pulmonary Arterial Hypertension (WHO functional class II-III) of the following types: - Idiopathic - Familial - Associated with: Corrected congenital systemic-to-pulmonary shunts Drugs and toxinsPatients are already on prescribed bosentan therapy for at least 12 weeks.
Registration Number
EUCTR2005-005066-37-DE
Lead Sponsor
Actelion Pharmaceuticals Ltd.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
44
Inclusion Criteria

1) Signed informed consent

2) Men or women >= 18 years of age

3) Symptomatic PAH (WHO functional class II-III) of the following types:
- Idiopathic
- Familial
- Associated with:
Corrected congenital systemic-to-pulmonary shunts
Drugs and toxins

4) PAH diagnosed by right heart catheter within 24 months before enrollment, showing:
- Mean pulmonary arterial pressure (mPAP) >= 25 mmHg
- Pulmonary capillary wedge pressure (PCWP) <= 15 mmHg

5) Documented non-responsiveness to acute vasoreactivity testing done within 24 months before enrollment but before start of bosentan therapy

6) Treated with bosentan 125 mg b.i.d. as monotherapy for PAH for at least 12 weeks before enrollment

7) Patient stable for at least 12 weeks before enrollment

8) Right heart catheterization for 2-3 hours medically acceptable

9) Pulmonary vascular resistance (PVR) at baseline 1 on the day of study performance >= 320 dyn.sec/cm5

10) Women of childbearing potential must have a negative pre-treatment urine pregnancy test and use a reliable method of contraception during bosentan treatment and for at least 3 months after bosentan treatment termination.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

1) Other types of PAH than listed above

2) Epoprostenol treatment planned

3) Suspected pulmonary veno-occlusive disease based on pulmonary edema during a previous vasoreactivity test or on abnormal findings compatible with that diagnosis (septal lines or pulmonary edema at high resolution computer tomography)

4) Systolic blood pressure < 85 mmHg

5) Body weight < 40 kg

6) Hemoglobin <75% of the lower limit of the normal range

7) AST and/or ALT > 3 times the upper limit of normal ranges

8) Moderate to severe hepatic impairment, i.e., Child-Pugh Class B or C

9) Psychotic, addictive or other disorder limiting the ability to provide informed consent or to comply with study requirements

10) Conditions that prevent compliance with the protocol or adherence to therapy

11) Pregnancy or breast-feeding

12) Hypersensitivity to bosentan, sildenafil, or any of the excipients of their formulations

13) Use of an investigational drug within 3 months before enrollment

14) Treatment with PAH drugs, including endothelin receptor antagonists other than bosentan, PDE-5 inhibitors incl sildenafil, parenteral treatment (e.g., epoprostenol), other prostanoids, NO, or L-arginine within 3 months before enrollment

15) Treatment with calcineurin inhibitors (e.g., cyclosporine A, tacrolimus, everolimus, sirolimus), fluconazole, ketoconazole, miconazole, amiodarone, ritonavir, glibenclamide (glyburide), alpha-blockers, nitrates, or calcium antagonists within 3 months before enrollment

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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