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Clinical Trials/2025-521769-29-00
2025-521769-29-00RecruitingPhase 3

A Long-term Open-Label Extension Study of Treprostinil Palmitil Inhalation Powder for Treatment of Pulmonary Hypertension Associated with Interstitial Lung Disease

Insmed Inc.66 sites in 10 countries165 target enrollmentStarted: September 7, 2026Last updated:
Conditions
Interventions
Drugs

Trial Snapshot

Phase
Phase 3
Status
Recruiting
Enrollment
165
Locations
66
Primary Endpoint
AEs, laboratory assessments, vital signs, physical examination, 12-lead ECG, and supplemental oxygen use

Study Overview

Brief Summary

To evaluate the safety and tolerability of the long-term use of TPIP in participants with PHILD from Study INS1009-311

Study Design

Allocation
Non Randomized
Primary Purpose
Treatment
Masking
None

Eligibility Criteria

Ages
18 years to 65+ years (18-64 Years, 65+ Years)
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Participants who have completed the lead-in PH-ILD TPIP Study INS1009-
  • Capable of giving signed informed consent that includes compliance with the requirements and restrictions listed in the ICF and in this protocol.
  • Agree not to participate in any other interventional trials or use investigational drugs or devices while participating in the INS1009-312 study.

Exclusion Criteria

  • Participants who experienced any AEs evaluated as causally related to TPIP by the Investigator in a lead-in study , which in the opinion of the Investigator, could pose an unreasonable risk of continued treatments for the participant.
  • Current use or expected need for PAH-approved therapy, including prostacyclin, prostacyclin analogues or other prostacyclin receptor agonists, endothelin receptor antagonists, and/or soluble guanylate cyclase stimulator, or any PH-ILD approved treprostinil therapy. Use of phosphodiesterase 5 inhibitors in line with applicable guidelines is allowed.
  • Pregnant or breastfeeding. Male and female (WOCBP) participants must use contraceptives that are consistent with local regulations regarding the methods of contraception for those participating in clinical studies (contraceptive guidance is located in Section 10.4). Female participants of childbearing potential must have a negative urine pregnancy test result at trial entry before the first dose of study drug. Additional requirements for pregnancy testing during and after study intervention are located in Section 8.4.5 and Section 8.5.
  • Any medical or psychological condition, including relevant laboratory abnormalities that, in the opinion of the Investigator, may present an unreasonable risk to the study participant as a result of his/her participation in this clinical trial, may impede their ability complete the study or the study assessments or confound the outcomes of the trial.
  • Diagnosis of Pulmonary Hypertension WHO Groups 1, 2, 4, or 5, or subtypes of PH WHO Group 3 other than interstitial lung disease (including combined pulmonary fibrosis and emphysema)
  • Evidence of left ventricular failure, HFpEF or postcapillary PH
  • Platelet count <50.0 x 103/μL at Enrollment, and/or unexplained coagulation abnormalities in repeated laboratory tests.
  • Known hypersensitivity or contraindication to treprostinil or TPIP or TPIP formulation excipients (eg, mannitol, leucine).

Arms & Interventions

TREPROSTINIL PALMITIL INHALATION POWDER, TREPROSTINIL PALMITIL INHALATION POWDER, TREPROSTINIL PALMITIL INHALATION POWDER, TREPROSTINIL PALMITIL INHALATION POWDER

Test

Intervention: TREPROSTINIL PALMITIL INHALATION POWDER (Drug)

Placebo (inhalation powder capsules) containing 1 of 4 dosage strengths of TPIP (80 μg, 160 μg, or 320 μg or 640 µg). The placebo product does not contain active substance and is otherwise identical to the IMP

Placebo

Intervention: Placebo (inhalation powder capsules) containing 1 of 4 dosage strengths of TPIP (80 μg, 160 μg, or 320 μg or 640 µg). The placebo product does not contain active substance and is otherwise identical to the IMP (Drug)

Outcomes

Primary Outcomes

AEs, laboratory assessments, vital signs, physical examination, 12-lead ECG, and supplemental oxygen use

AEs, laboratory assessments, vital signs, physical examination, 12-lead ECG, and supplemental oxygen use

Secondary Outcomes

  • Change in 6MWD measured post-dose from pre-OLE Baseline up to 104 weeks
  • Absolute and percent change from pre-OLE Baseline in FVC, FVC% pred, FEV1, and FEV1% pred up to 104 weeks
  • Change in NT-proBNP plasma concentration from pre-OLE Baseline up to 104 weeks
  • Annualized rate of ILD exacerbations during the OLE study (104 weeks)
  • Proportion of participants with a clinical worsening event. Clinical worsening events are defined as one of the following: • Hospitalization due to a cardiopulmonary indication related to the disease under study
  • • Deterioration of PH-ILD, defined as a combination of the following changes from Baseline attributable to the disease under study: − decrease in 6MWD ≥15%, confirmed by 2 tests at least 4 hours but not more than 1 week apart, AND − signs/symptoms of worsened right heart failure or worsened WHO/NYHA functional class. • Lung transplantation (except for when preplanned prior to the study) • Death from any cause
  • Mean change in L-PF total symptom domain score from pre-OLE Baseline up to 104 weeks Mean change from pre-OLE Baseline up to 104 weeks in: • L-PF cough domain score • L-PF dyspnea domain score • L-PF impact domain score
  • Mean change from pre-OLE Baseline up to 104 weeks in: • EQ-5D-5L index score • EQ-5D-5L VAS
  • Proportion of participants with a major morbidity or mortality event, defined as one of the following: • Hospitalization due to a cardiopulmonary indication related to the disease under study • Lung transplantation (except for when pre-planned prior to the study) • Death from any cause

Investigators

Sponsor Class
Pharmaceutical company
Responsible Party
Principal Investigator
Principal Investigator

Natasha Makulova

Scientific

Insmed Inc.

Study Sites (66)

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