MedPath

Frespaciguat (MK-5475) INSIGNIA-PH-COPD: A Study of the Efficacy and Safety of Frespaciguat (an Inhaled sGC Stimulator) in Adults With PH-COPD

Phase 2
Recruiting
Conditions
Pulmonary Hypertension
Chronic Obstructive Pulmonary Disease
Interventions
Drug: Frespaciguat
Drug: Placebo
Registration Number
NCT05612035
Lead Sponsor
Merck Sharp & Dohme LLC
Brief Summary

Researchers are looking for ways to treat pulmonary hypertension (PH) caused by chronic obstructive pulmonary disease (COPD). The goal of the study is to learn if people who take frespaciguat can walk farther in 6 minutes at Week 24 compared to people who take placebo.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
120
Inclusion Criteria
  • Has Group 3.1 pulmonary hypertension chronic obstructive pulmonary disease (PH-COPD) as defined by the Clinical Classification of Pulmonary Hypertension.
  • Has a right heart catheterization (RHC) at screening or historical RHC within 12 months before screening that meets hemodynamic criteria.
  • Has a physician diagnosis of obstructive lung disease on pulmonary function testing (PFT) performed at screening.
  • Has a WHO Functional Class assessment of Class II to IV.
  • If on supplemental oxygen, the regimen must be stable.
  • Has stable and optimized chronic, baseline COPD-specific therapy.
  • If on PDE5 inhibitor, has stable concomitant use (initiated at least 3 months prior to randomization and no change in drug or dosage for at least 3 months prior to randomization) and changes to PDE5 inhibitor dosing is not anticipated during the 24 week Base Period.
  • If on antihypertensives and/or a diuretic regimen has stable concomitant use.
  • If on anticoagulants has stable concomitant use.
  • Is of any sex/gender from 40 to 85 years of age inclusive.
  • Female is not pregnant or breastfeeding, and is not of childbearing potential or uses acceptable contraceptive method or abstains from sexual intercourse, or has a negative highly sensitive pregnancy test within 24 hours before the first dose of study intervention, or whose history and sexual activity has been reviewed by the investigator.

Exclusion criteria:

  • Has Group 1 pulmonary arterial hypertension (PAH), Groups 2, 4 or 5 pulmonary hypertension (PH).
  • Has non-COPD related Group 3 PH.
  • Has evidence of untreated more than mild obstructive sleep apnea.
  • Has significant left heart disease.
  • Expects to receive a lung and/or heart transplant from screening through the end of the 24 week Base Period.
  • Has evidence of a resting oxygen saturation (SpO2) < 88%.
  • Has experienced a moderate or severe COPD exacerbation within 2 months before randomization.
  • Has experienced right heart failure within 2 months before randomization.
  • Has uncontrolled tachyarrhythmia.
  • Has acute coronary syndrome, undergone coronary artery bypass graft, or percutaneous coronary intervention within 2 months before randomization.
  • Has evidence of significant chronic renal insufficiency.
  • Has evidence of chronic liver disease, portal hypertension, cirrhosis, or hepatic abnormalities.
  • Initiated a pulmonary rehabilitation program within 2 months before randomization.
  • Has impairments that limit the ability to perform 6MWT.
  • Has history of cancer.
  • Is a user of illicit drugs or has a recent history of drug/alcohol abuse or dependence.
  • Has used PAH-specific therapies within 2 months of randomization.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
FrespaciguatFrespaciguatParticipants with PH-COPD will receive 380 µg of frespaciguat as an oral inhalation once daily for 24 weeks (base period) and thereafter for up to 42 months (optional extension period).
PlaceboFrespaciguatParticipants with PH-COPD will receive matching placebo as an oral inhalation once daily for 24 weeks (base period) and then 380 µg of frespaciguat as an oral inhalation once daily for up to 42 months (optional extension period).
PlaceboPlaceboParticipants with PH-COPD will receive matching placebo as an oral inhalation once daily for 24 weeks (base period) and then 380 µg of frespaciguat as an oral inhalation once daily for up to 42 months (optional extension period).
Primary Outcome Measures
NameTimeMethod
Mean Change From Baseline in 6-minute Walk Distance (6MWD) at Week 24Baseline and Week 24

6MWD is assessed using the 6-minute walk test (6MWT).

Secondary Outcome Measures
NameTimeMethod
Mean Change From Baseline in NT-ProBNP at Week 24Baseline and Week 24

NT-proBNP was measured at baseline and Week 24

Percentage of Participants Whose World Health Organization-Functional Class (WHO-FC) Does not Worsen Relative to Baseline at Week 12Baseline and Week 12

Participants are assigned one of four WHO-FC, dependent on limits of physical activity. As WHO-FC increases from I to IV, limits of physical activity increase.

Percentage of Participants Whose WHO-FC Does not Worsen Relative to Baseline at Week 24Baseline and Week 24

Participants are assigned one of four WHO-FC, dependent on limits of physical activity. As WHO-FC increases from I to IV, limits of physical activity increase.

Percentage of Participants With One or More Adverse Events (AEs)Up to Week 206

An adverse event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.

Percentage of Participants who Discontinued Study Treatment due to an AEUp to Week 204

An adverse event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The percentage of participants who discontinue study treatment due to an AE will be presented.

Mean Change From Baseline in 6MWD at Week 12Baseline and Week 12

6MWD is assessed using the 6-minute walk test (6MWT).

Mean Change From Baseline in N-Terminal Pro B-Type Natriuretic Peptide (NT-proBNP) at Week 12Baseline and Week 12

NT-proBNP was measured at baseline and Week 12.

Trial Locations

Locations (84)

UCSF Helen Diller Medical Center at Parnassus Heights ( Site 0110)

🇺🇸

San Francisco, California, United States

University of Colorado Anschutz Medical Campus-University of Colorado Hospital Cardiac and Vascular ( Site 0101)

🇺🇸

Aurora, Colorado, United States

Clinovation Intl. Corp. ( Site 0108)

🇺🇸

Sebring, Florida, United States

Alexian Brothers Medical Center-Pulmonary ( Site 0109)

🇺🇸

Elk Grove Village, Illinois, United States

University of Iowa ( Site 0103)

🇺🇸

Iowa City, Iowa, United States

University of Kansas Medical Center-IM-Pulmonary and Critical Care Medicine ( Site 0102)

🇺🇸

Kansas City, Kansas, United States

Lexington VA Medical Center - Cooper Division ( Site 0137)

🇺🇸

Lexington, Kentucky, United States

Corewell Health ( Site 0133)

🇺🇸

Grand Rapids, Michigan, United States

Mayo Clinic in Rochester, Minnesota ( Site 0131)

🇺🇸

Rochester, Minnesota, United States

Creighton University Clinical Research Office ( Site 0123)

🇺🇸

Omaha, Nebraska, United States

Scroll for more (74 remaining)
UCSF Helen Diller Medical Center at Parnassus Heights ( Site 0110)
🇺🇸San Francisco, California, United States
Study Coordinator
Contact
415-353-2296

MedPath

Empowering clinical research with data-driven insights and AI-powered tools.

© 2025 MedPath, Inc. All rights reserved.