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A Study of RVT-1201 in Patients With Pulmonary Arterial Hypertension (ELEVATE 1)

Phase 2
Terminated
Conditions
Pulmonary Arterial Hypertension
Interventions
Drug: Placebo
Registration Number
NCT03924154
Lead Sponsor
Altavant Sciences GmbH
Brief Summary

This is an exploratory Phase 2a, randomized, double-blind, placebo-controlled, parallel-group, multicenter study to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamic effects of RVT-1201 in patients with pulmonary arterial hypertension (PAH).

Detailed Description

This is an exploratory Phase 2a, randomized, double-blind, placebo-controlled, parallel-group, multicenter study to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamic effects of RVT-1201 in patients with pulmonary arterial hypertension (PAH).

Study participation for each patient will last approximately 3 months and will consist of a screening period (up to 28 days in duration), a baseline period (day 1, pre-dose), a 6-week treatment period, and a 2-week follow-up period.

The study will enroll approximately 36 patients at approximately 20 centers across the United States and Canada.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
3
Inclusion Criteria
  • Symptomatic PAH belonging to one of the following types:

    • Idiopathic
    • Heritable
    • Drug- or toxin- induced
    • Associated with one of the following: connective tissue disease or congenital heart disease
  • World Health Organization (WHO) Functional Class (FC) II or III

  • PAH diagnosed by right heart cardiac catheterization prior to Screening

  • Receiving standard of care treatment for PAH with oral monotherapy or dual therapy for at least 12 weeks prior to Screening at a dose which has been stable for at least 8 weeks prior to Screening

  • If on a diuretic, dose must be stable for at least 4 weeks prior to Screening, with no changes anticipated during study participation

  • 6-Minute Walk Distance (6MWD) between 150 and 500 meters at Screening and Baseline visits

  • Plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) level ≥ 300 pg/mL at Screening

  • Ability and willingness to give written informed consent and to comply with the requirements of the study

Key

Exclusion Criteria
  • PAH associated with human immunodeficiency virus (HIV) infection, portal hypertension or schistosomiasis

  • Other types of pulmonary hypertension (PH):

    • Pulmonary hypertension due to left heart disease (WHO PH Group 2)
    • Pulmonary hypertension due to lung diseases and/or hypoxia (WHO PH Group 3)
    • Chronic thromboembolic pulmonary hypertension (WHO PH Group 4)
    • Pulmonary hypertension with unclear multifactorial mechanisms (WHO PH Group 5)
  • Hospitalization for pulmonary hypertension within 12 weeks of screening

  • Cardiopulmonary rehabilitation program based on exercise (planned, or started ≤ 12 weeks prior to Screening)

  • Prostanoid or prostacyclin receptor agonist therapy within 12 weeks of screening

  • Evidence of left-sided heart disease

  • If Pulmonary function tests were done prior to screening, Pulmonary function tests demonstrate obstructive or restrictive lung disease

  • Use of telotristat (Xermelo®) within the last 6 months

  • Use of any investigational drug within 30 days or five half-lives (whichever is longer) prior to Screening, or 90 days if an investigational drug for PAH

  • Have uncontrolled atrial fibrillation (AFib) or other uncontrolled arrhythmias

  • Body mass index (BMI) >45 kg/m2

  • Women of childbearing potential who are pregnant, planning to become pregnant, or lactating or female/male patients unwilling to use effective contraception

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboMatching placebo tablet, administered orally twice daily with food for 6 weeks, in addition to the patient's current standard of care medication(s) for PAH (n=12 \[Anticipated\])
RVT-1201RVT-1201RVT-1201 600 mg immediate-release tablet, administered orally twice daily with food for 6 weeks, in addition to the patient's current standard of care medication(s) for PAH (n=24 \[Anticipated\])
Primary Outcome Measures
NameTimeMethod
Adverse events (AEs) and discontinuations due to AEs8 weeks

Incidence of treatment-emergent adverse events (TEAEs), drug-related adverse events (AEs), and discontinuations due to AEs

Secondary Outcome Measures
NameTimeMethod
Concentration of biomarkers of serotonin biosynthesis in urine8 weeks

Concentration of urine 5-hydroxyindoleacetic acid (5-HIAA) will be normalized against urine creatinine concentration to determine absolute ratio and percent change from baseline in urine 5-HIAA:creatinine ratio

Area under the plasma concentration versus time curve (AUC) of KAR5417 (the active metabolite of RVT-1201)6 weeks

Measured KAR5417 plasma concentrations from sparse sampling will be used to assess the pharmacokinetic (PK) parameter AUC of KAR5417 administered twice daily in patients with PAH, by means of population PK (PopPK) analysis

Relationship between KAR5417 exposure and percent change from baseline in plasma concentrations of the serotonin-related biomarkers6 weeks

Evaluate the relationship between exposure (area under the plasma concentration versus time curve \[AUC\]) of KAR5417 (the active metabolite of RVT-1201) and percent change from baseline in plasma concentrations of the serotonin-related biomarkers (5-HIAA and 5-HT)

Concentration of biomarkers of serotonin biosynthesis in plasma8 weeks

Absolute concentrations and percent change from baseline in plasma 5-hydroxyindoleacetic acid (5-HIAA) and plasma 5-hydroxytryptamine (5-HT, also known as serotonin) concentrations

Study drug (RVT-1201) and active metabolite (KAR5417) plasma concentrations6 weeks

Measured RVT-1201 and KAR5417 plasma concentrations from sparse sampling

Relationship between KAR5417 exposure and percent change from baseline in urine concentrations of the serotonin-related biomarkers6 weeks

Evaluate the relationship between exposure (area under the plasma concentration versus time curve \[AUC\]) of KAR5417 (the active metabolite of RVT-1201) and percent change from baseline in urine 5-HIAA:creatinine concentration ratio

Trial Locations

Locations (23)

SBPA Research LLC

🇺🇸

Santa Barbara, California, United States

Kentuckiana Pulmonary Research Center

🇺🇸

Louisville, Kentucky, United States

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

London Health Sciences Centre

🇨🇦

London, Ontario, Canada

San Marcus Research Clinic, Inc.

🇺🇸

Miami Lakes, Florida, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

Central Florida Pulmonary Group, P.A.

🇺🇸

Orlando, Florida, United States

Pulmonary Research Institute of Southeast Michigan

🇺🇸

Farmington Hills, Michigan, United States

University of Texas Health Science Center at Houston, McGovern Medical School

🇺🇸

Houston, Texas, United States

University of Calgary

🇨🇦

Calgary, Alberta, Canada

University of Florida

🇺🇸

Gainesville, Florida, United States

University of Alberta

🇨🇦

Edmonton, Alberta, Canada

Pulmonary Associates, PA

🇺🇸

Phoenix, Arizona, United States

George Washington Medical Faculty Associates - Pulmonary Hypertension Program

🇺🇸

Washington, District of Columbia, United States

University of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

Baystate Medical Center

🇺🇸

Springfield, Massachusetts, United States

Oregon Health & Science University

🇺🇸

Portland, Oregon, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

University of California Davis Medical Center

🇺🇸

Sacramento, California, United States

University of Colorado

🇺🇸

Aurora, Colorado, United States

Louisiana State University Health Sciences Center

🇺🇸

New Orleans, Louisiana, United States

University of Texas Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

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