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An Open-Label Extension Trial of UT-15C Sustained-release (SR) in Subjects With Pulmonary Arterial Hypertension

Phase 3
Completed
Conditions
Pulmonary Arterial Hypertension
Interventions
Registration Number
NCT01027949
Lead Sponsor
United Therapeutics
Brief Summary

This study provided/continued to provide oral treprostinil (UT-15C SR; treprostinil diethanolamine) to eligible subjects who participated in Studies TDE-PH-202, TDE-PH-203, TDE-PH-205, TDE-PH-301, TDE-PH-302, and TDE-PH-308. The study assessed the long term safety of oral treprostinil and the effect of continued treatment with oral treprostinil on exercise capacity after 1 year of treatment.

Detailed Description

This was an international, multicenter, open-label study designed to provide oral treprostinil for eligible subjects who participated in Studies TDE-PH-301, TDE-PH-302, TDE-PH-308, TDE-PH-202, TDE PH 203, and TDE-PH-205. Subjects randomly allocated to receive oral treprostinil in Studies TDE-PH-301, TDE-PH-302, or TDE-PH-308 and enrolled in this open-label study completed visits at Months 6, 12, 24, 36, and yearly visits thereafter. Subjects randomly allocated to receive placebo in Studies TDE-PH-301, TDE-PH-302, or TDE-PH-308 completed visits at Months 3, 6, 12, 24, 36, and yearly visits thereafter. Subjects that transitioned from Studies TDE-PH-202, TDE-PH-203, and TDE-PH-205 (that had an open-label study design) followed the regimen for subjects receiving oral treprostinil. A 6-Minute Walk Test (6MWT) and Borg dyspnea score were conducted at the visit which occurred 12 months after the subject's first exposure to oral treprostinil.

Adverse events (AEs) were reported continuously throughout the study; any AEs ongoing at the time of discharge from Studies TDE PH-301, TDE PH-302, TDE-PH-308, TDE-PH-202, TDE-PH-203, and TDE-PH-205 were recorded as AEs and marked as "ongoing from previous study" in the subject's electronic Case Report Form (eCRF). Study drug dosing and pulmonary arterial hypertension (PAH) concomitant medication usage were assessed at each scheduled study visit and recorded in the subject's eCRF.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
894
Inclusion Criteria
  1. The subject remained on study drug and completed all assessments during the Treatment Phase of the previous study (TDE-PH-202, TDE-PH-203, TDE-PH-205, TDE-PH-301, TDE PH-302, or TDE-PH-308) OR the subject permanently discontinued study drug during the Treatment Phase of the previous study due to clinical worsening (as defined in the protocol of the previous study), completed premature termination assessments prior to discontinuing study drug, completed all remaining scheduled study visits, AND received placebo during the Treatment Phase of the previous studies OR the subject was randomized into Group 1 or Group 2 in Study TDE PH 202, permanently discontinued study drug during the 12-week Treatment Phase due to clinical worsening, completed all premature termination assessments prior to discontinuing study drug, and completed all remaining scheduled study visits and assessments (with the exception of the hemodynamic measurements) through Week 12. Such subjects should have started treatment with oral treprostinil in the open-label study at 0.25 mg twice daily (BID).
  2. The subject voluntarily gave informed consent to participate in the study.
  3. Women of childbearing potential includes any female who had experienced menarche and who had not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or was not postmenopausal (defined as amenorrhea for at least 12 consecutive months). Sexually active women of childbearing potential must have used 2 effective forms of contraception during the length of the study. Medically acceptable forms of effective contraception included: (1) approved hormonal contraceptives (such as birth control pills), (2) barrier methods (such as a condom or diaphragm) used with a spermicide, (3) an intrauterine device, (4) partner vasectomy, or (5) abstinence. Males participating in the study must have used a condom during the length of the study, and for at least 48 hours after discontinuing study medication. Protocol Amendment A.1AU included the required assessment for Austrian subjects to perform urine pregnancy tests every 4 weeks during the study.
Exclusion Criteria
  1. The subject permanently discontinued study drug during the previous study (TDE PH 202, TDE-PH-203, TDE PH 205, TDE-PH-301, TDE-PH-302, or TDE PH 308) due to treatment-related adverse events (AEs).
  2. The subject permanently discontinued study drug during the Treatment Phase of the previous study (TDE-PH-202, TDE-PH-203, TDE-PH-205, TDE-PH-301, TDE-PH-302, or TDE-PH-308) due to clinical worsening (as defined in those study protocols) and did not undergo premature termination assessments prior to discontinuing study drug, and/or did not complete all remaining study visits through the final scheduled visit.
  3. The subject prematurely discontinued study drug during the Treatment Phase of the previous study due to clinical worsening (as defined in those study protocols), completed premature termination assessments prior to discontinuing study drug, completed all remaining scheduled study visits AND received oral treprostinil during the Treatment Phase of the previous study (TDE PH-202, TDE-PH-203, TDE-PH-301, TDE-PH-302, or TDE PH-308). Subjects enrolled in Study TDE-PH-202 who were randomized into the individual maximum tolerated dose (iMTD) group who clinically worsened could not participate. Subjects who permanently discontinued study drug during the 12-week Treatment Phase due to treatment-related AEs were not eligible even if they completed all remaining scheduled study visits. Subjects who permanently discontinued study drug during the 12 week Treatment Phase and did not undergo premature termination assessments prior to discontinuing study drug and/or who did not complete all remaining study visits through the Week 12 visit were also not eligible.
  4. The subject developed any concurrent illness or condition during the conduct of the previous study, including but not restricted to: sleep apnea, chronic renal insufficiency, anemia, uncontrolled systemic hypertension, or left sided heart disease, unless their physician felt that entry into this study would not be detrimental to their overall health.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Oral TreprostinilOral TreprostinilSubjects from previous studies TDE-PH-202 (NCT01104870), TDE-PH-203 (NCT01477333), and TDE-PH-205 (NCT01588405), TDE-PH-301 (NCT00325442), TDE-PH-302 (NCT00325403), or TDE PH-308 (NCT00887978). Subjects were instructed to take the appropriate amount of 0.125, 0.25, 0.5, 1, and/or 2.5 mg tablets based upon their prescribed dose. Investigators were instructed to increase the dose of oral treprostinil in the absence of dose limiting drug-related AEs to ensure each subject received the optimal clinical dose throughout the study
Primary Outcome Measures
NameTimeMethod
Change in Exercise Capacity at Month 12From First Visit (Visit 1) to Month 12

Assess the effect of continued therapy with oral treprostinil on exercise capacity as assessed by the change from Baseline in 6-Minute Walk Test (6MWT) after 1 year of treatment. The 6MWT is the clinical standard for assessing subject functional status in the treatment of PAH and has been considered an objective measure of subject functional status by the American Thoracic Society. The distance a subject can walk in 6 minutes is recorded in meters.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (134)

Zentrum für Lungenhochdruck Thoraxklinik am Universitätsklinikum Heidelberg

🇩🇪

Hamburg, Germany

Dipartimento di Scienze Cardiovascolari, Respiratorie e Morfologiche

🇮🇹

Rome, Italy

Unidad de Investigacion Clinica en Medicina S.C.

🇲🇽

Monterrey, Mexico

University of California, San Francisco-Fresno

🇺🇸

Fresno, California, United States

West Los Angeles VA Healthcare Center

🇺🇸

Los Angeles, California, United States

David Geffen School of Medicine at UCLA

🇺🇸

Los Angeles, California, United States

Harbor-UCLA Medical Center

🇺🇸

Torrance, California, United States

The University of Chicago Hospitals

🇺🇸

Chicago, Illinois, United States

University of Maryland Medical Center

🇺🇸

Baltimore, Maryland, United States

Johns Hopkins Outpatient Center

🇺🇸

Baltimore, Maryland, United States

Hospital of the University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

UPMC Presbyterian Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

London Health Sciences Center Victoria Hospital

🇨🇦

Toronto, Ontario, Canada

Poona Hospital and Research Centre

🇮🇳

Pune, Maharashtra, India

University of Iowa Hospitals and Clinics

🇺🇸

Iowa City, Iowa, United States

The Prince Charles Hospital

🇦🇺

Chermside West, Australia

Tufts Medical Center

🇺🇸

Boston, Massachusetts, United States

Brigham and Woman's Hospital

🇺🇸

Boston, Massachusetts, United States

Baylor College of Medicine

🇺🇸

Houston, Texas, United States

UCSD Medical Center

🇺🇸

San Diego, California, United States

The Carl and Ethyl Linder Center for Research and Education at the Christ Church

🇺🇸

Cincinnati, Ohio, United States

University of California San Francisco Medical Center

🇺🇸

San Francisco, California, United States

University of Minnesota Medical Center, Fairview

🇺🇸

Minneapolis, Minnesota, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

The University of Texas Health Science Center at San Antonio

🇺🇸

San Antonio, Texas, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Mayo Clinic Phoenix

🇺🇸

Phoenix, Arizona, United States

Arizona Pulmonary Specialists, Ltd.

🇺🇸

Phoenix, Arizona, United States

Alexandria Cardiology Clinic

🇺🇸

Alexandria, Louisiana, United States

Peter Lougheed Centre

🇨🇦

Calgary, Alberta, Canada

Universitaetsklinik für Innere Medizin Innsbruck

🇦🇹

Wien, Austria

Life Care Institute of Medical Sciences & Research

🇮🇳

Ahmedabad, India

Europejskie Centrum Zdrowia Otwock

🇵🇱

Warsaw, Poland

Oddzial Kardiologiczny

🇵🇱

Wroclaw, Poland

Care Institute of Medical Sciences

🇮🇳

Ahmedabad, Gujarat, India

University of Cincinnati

🇺🇸

Cincinnati, Ohio, United States

St. Joseph's Hospital and Medical Center

🇺🇸

Phoenix, Arizona, United States

Sir Ganga Ram Hospital

🇮🇳

New Delhi, India

Rambam Medical Center

🇮🇱

Haifa, Israel

Hadassah Hebrew University Medical Center

🇮🇱

Jerusalem, Israel

Klinika Chorób Serca i Naczyń, Krakowski Szpital Specjalistyczny im. Jana Pawla II

🇵🇱

Kraków, Poland

University of Michigan Health System

🇺🇸

Ann Arbor, Michigan, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Maine Medical Center

🇺🇸

Portland, Maine, United States

University Hospitals of Cleveland

🇺🇸

Cleveland, Ohio, United States

Instituto Nacional de Cardiologia

🇲🇽

Mexico City, Mexico

Servico de Cardiologia Hospital de Santa Marta

🇵🇹

Lisbon, Portugal

Vancouver Coastal Health Authority Vancouver General Hospital

🇨🇦

Vancouver, British Columbia, Canada

Newark Beth Israel Medical Center

🇺🇸

Newark, New Jersey, United States

Medical University Graz

🇦🇹

Wein, Austria

University Hospital Gasthuisberg

🇧🇪

Leuven, Belgium

Sir Mortimer B. Davis Jewish General Hospital

🇨🇦

Montréal, Quebec, Canada

G. Kuppuswamy Naidu Memorial Hospital

🇮🇳

Coimbatore, India

PRIME Hospitals

🇮🇳

Hyderabad, India

Auxilio Mutuo Hospital CardioPulmonary Research Center

🇵🇷

Guaynabo, Puerto Rico

The Kirklin Clinic

🇺🇸

Birmingham, Alabama, United States

Legacy Pulmonary Clinic

🇺🇸

Portland, Oregon, United States

Oregon Health and Sciences University

🇺🇸

Portland, Oregon, United States

Policlinico S. Orsola Malpighi - Università degli studi di Bologna

🇮🇹

Bologna, Italy

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

Aurora Cardiovascular Services

🇺🇸

Milwaukee, Wisconsin, United States

University of Colorado Health Science Center

🇺🇸

Aurora, Colorado, United States

The Children's Hospital

🇺🇸

Aurora, Colorado, United States

University of Arizona Clinical and Translational Science (CATS) Research Center

🇺🇸

Tucson, Arizona, United States

UC Davis Medical Center

🇺🇸

Sacramento, California, United States

Stanford University, Pulmonary and Critical Care Medicine

🇺🇸

Stanford, California, United States

University of Florida College of Medicine Jacksonville

🇺🇸

Jacksonville, Florida, United States

Cleveland Clinic Florida

🇺🇸

Weston, Florida, United States

The Emory Clinic

🇺🇸

Atlanta, Georgia, United States

Kentuckiana Pulmonary Associates

🇺🇸

Louisville, Kentucky, United States

Winthrop University Hospital

🇺🇸

Mineola, New York, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Mary Parkes Center

🇺🇸

Rochester, New York, United States

University of North Carolina Hospitals

🇺🇸

Chapel Hill, North Carolina, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

Ohio State University

🇺🇸

Columbus, Ohio, United States

The University of Toledo Medical Center

🇺🇸

Toledo, Ohio, United States

Allegheny General Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

UT Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

University of Texas Medical School

🇺🇸

Houston, Texas, United States

Intermountain Medical Center

🇺🇸

Murray, Utah, United States

Inova Fairfax Hospital

🇺🇸

Falls Church, Virginia, United States

University of Washington Medical Center

🇺🇸

Seattle, Washington, United States

Heart/Lung Transplant Unit - St. Vincent's Hospital

🇦🇺

Darlinghurst, Australia

The Alfred Hospital

🇦🇺

Melbourne, Australia

Royal Perth Hospital

🇦🇺

Perth, Australia

Medizininische Universitaet Wien

🇦🇹

Wien, Austria

Department of Cardiology Erasme University Hospital

🇧🇪

Brussels, Belgium

Toronto General Hospital

🇨🇦

Toronto, Ontario, Canada

University of Alberta Hospital

🇨🇦

Edmonton, Alberta, Canada

Beijing Shijitan Hospital, Cadres Respiratory Department

🇨🇳

Beijing, China

Peking Union Medical College Hospital, Respiratory Medicine Department

🇨🇳

Beijing, China

Service Chirurgie Thoracique, Hôpital Haut Levêque

🇫🇷

Pessac, Pessac Cedex, France

Shanghai Pulmonary Hospital, Respiratory Medicine Department

🇨🇳

Shanghai, China

Centre d'Investigation Clinique Hôpital La Cavale Blanche - CHU Brest

🇫🇷

Brest, France

PMAC, Clinique de Pneumologie

🇫🇷

Bernin, France

Hospital Antoine Beclere

🇫🇷

Clamart, France

Hôpital Louis Pradel

🇫🇷

Lyon, France

Hospital Claude Huriez

🇫🇷

Lille Cedex, France

CHU Arnaud de Villeneuve - Service maladies respiratoires

🇫🇷

Montpellier cedex 5, France

Universitätsklinikum Dresden Abtl. Pneumologie

🇩🇪

Dresden, Germany

Service de Pneumologie Centre de Competence pour l'HTAP- Pole des Voies Respiratoires Hôpital Larrey

🇫🇷

Toulouse, France

University Hospital Greifswald

🇩🇪

Greifswald, Germany

Universitatsklinikum Hamburg Eppendorf

🇩🇪

Hamburg, Germany

DRK Kliniken Berlin Köpenick

🇩🇪

Hamburg, Germany

Universitätsklinkium Köln Klinik III für Innere Medizin

🇩🇪

Hamburg, Germany

Medizinische Hochschule Hannover (MHH)

🇩🇪

Hannover, Germany

Dept. of Internal Medicine III University Heidelberg

🇩🇪

Heidelberg, Germany

Narayana Hrudayalaya Hospitals

🇮🇳

Bangalore, Karnataka, India

Sri Ramachandra Medical College & Research Institute

🇮🇳

Chennai, India

Asian Heart Institute & Research Centre Pvt. Ltd.

🇮🇳

Mumbai, Maharashtra, India

Queen's NRI Hospital

🇮🇳

Visakhapatnam, India

Pulmonary Hypertension Unit Centre for Lung Health Mater Misericordiae University Hospital

🇮🇪

Dublin, Ireland

The Lady Davis Carmel Medical Center

🇮🇱

Haifa, Israel

Pulmonary Institute Rabin Medical Center (Belinson Kampus)

🇮🇱

Petah Tiqva, Israel

Azienda Ospedaliera di Rilievo Nazionale Monaldi - Cotugno-CTO Cardiologia S.U.N.

🇮🇹

Napoli, Italy

Pulmonary Institute Chaim Sheba Medical Center

🇮🇱

Ramat Gan, Israel

Hospital Universitario de la UANL

🇲🇽

Monterrey, Mexico

Radboud University Nijmegen Medical Center

🇳🇱

Amsterdam, Netherlands

VU Medish Centrum

🇳🇱

Amsterdam, Netherlands

Hospital 12 de Octubre

🇪🇸

Madrid, Spain

Freeman Hospital

🇬🇧

Newcastle, United Kingdom

Royal Free Hospital

🇬🇧

London, United Kingdom

Skane University Hospital

🇸🇪

Lund, Sweden

Hospital Clínic I Provincial

🇪🇸

Barcelona, Spain

Hospital Vall d'Hebron

🇪🇸

Barcelona, Spain

Papworth Hospital

🇬🇧

Cambridge, United Kingdom

Royal Hallamshire Hospital

🇬🇧

Sheffield, United Kingdom

Papworth Hospital NHS Foundation Trust

🇬🇧

Glasgow, United Kingdom

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

University Medical Center

🇺🇸

Tucson, Arizona, United States

Ruby Hall Clinic

🇮🇳

Pune, India

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

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