NCT04896008已完成3 期
A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate Sotatercept When Added to Maximum Tolerated Background Therapy in Participants With Pulmonary Arterial Hypertension (PAH) World Health Organization (WHO) Functional Class (FC) III or FC IV at High Risk Mortality
Acceleron Pharma, Inc., a wholly-owned subsidiary of Merck & Co., Inc., Rahway, NJ USA57 个研究点 分布在 9 个国家目标入组 173 人开始时间: 2021年12月1日最近更新:
适应症
干预措施
相关药物
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 发起方
- 入组人数
- 173
- 试验地点
- 57
- 主要终点
- Time to First Confirmed Morbidity or Mortality Event
研究概览
简要总结
The objective of this study is to evaluate the effects of sotatercept (MK-7962, formerly called ACE-011) treatment (plus maximum tolerated background pulmonary arterial hypertension [PAH] therapy) versus placebo (plus maximum tolerated background PAH therapy) on time to first event of all cause death, lung transplantation, or PAH worsening-related hospitalization of ≥24 hours, in participants with World Health Organization (WHO) functional class (FC) III or FC IV PAH at high risk of mortality.
详细描述
This is a phase 3, randomized, double-blind, placebo-controlled study to evaluate sotatercept when added to maximum tolerated background PAH therapy on time to first event of all-cause death, lung transplantation, or PAH worsening related hospitalization of ≥24 hours, in participants with WHO FC III PAH or WHO FC IV PAH at high risk of mortality.
Participants who were eligible for this study presented with symptomatic PAH that was classified as idiopathic, heritable, drug- or toxin-induced, associated with connective tissue disease, or post-shunt correction.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Triple (Participant, Care Provider, Investigator)
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Documented diagnostic right heart catheterization prior to screening confirming the diagnosis of WHO PAH Group 1 in any of the following subtypes:
- •Idiopathic PAH
- •Heritable PAH
- •Drug/toxin-induced PAH
- •PAH associated with CTD
- •PAH associated with simple, congenital systemic to pulmonary shunts at least 1 year following repair
- •Symptomatic PAH classified as WHO FC III or IV
- •REVEAL Lite 2.0 risk score of ≥9
- •Right heart catheterization performed during screening (or within 2 weeks prior to screening, if done at the clinical study site) documenting a minimum PVR of ≥5 Wood units and a pulmonary capillary wedge pressure (PCWP) or left ventricular end-diastolic pressure (LVEDP) of ≤15 mmHg
- •Clinically stable and on stable doses of maximum tolerated (per investigator's judgment) double or triple background PAH therapies for at least 30 days prior to screening
- •Females of childbearing potential must:
- •Have 2 negative urine or serum pregnancy tests as verified by the investigator prior to starting study therapy; must agree to ongoing urine or serum pregnancy testing during the course of the study and until 8 weeks after the last dose of the study drug
- •If sexually active with a male partner, have used, and agree to use highly effective contraception without interruption per protocol; for at least 28 days prior to starting the investigational product, during the study (including dose interruptions), and for 16 weeks (112 days) after discontinuation of study treatment
- •Refrain from breastfeeding a child or donating blood, eggs, or ovum for the duration of the study and for at least 16 weeks (112 days) after the last dose of study treatment
- •Male participants must:
- •Agree to use a condom, defined as a male latex condom or nonlatex condom NOT made out of natural (animal) membrane (e.g., polyurethane), during sexual contact with a pregnant female or a female of childbearing potential while participating in the study, during dose interruptions, and for at least 16 weeks (112 days) following investigational product discontinuation, even if he has undergone a successful vasectomy
- •Refrain from donating blood or sperm for the duration of the study and for 16 weeks (112 days) after the last dose of study treatment
- •Ability to adhere to study visit schedule and understand and comply with all protocol requirements
- •Ability to understand and provide written informed consent
排除标准
- •Diagnosis of pulmonary hypertension (PH) WHO Groups 2, 3, 4, or 5
- •Diagnosis of the following PAH Group 1 subtypes: human immunodeficiency virus-associated PAH and PAH associated with portal hypertension
- •Diagnosis of pulmonary veno-occlusive diseases or pulmonary capillary hemangiomatosis or overt signs of capillary and/or venous involvement
- •Hemoglobin at screening above gender-specific upper limit of normal (ULN), per local laboratory test
- •Baseline platelet count <50,000/mm3 (<50.0 x 109/L) at screening
- •Baseline systolic blood pressure <85 mmHg at screening
- •Pregnant or breastfeeding women
- •Serum alanine aminotransferase or aspartate aminotransferase levels or total bilirubin >3.0×ULN
- •Currently enrolled in or have completed any other investigational product study within 30 days for small molecule drugs or within 5 half-lives for biologics prior to the date of signed informed consent
- •Prior exposure to sotatercept or known allergic reaction to sotatercept, its excipients or luspatercept
- •History of pneumonectomy
- •Untreated more than mild obstructive sleep apnea
- •History of known pericardial constriction
- •History of restrictive or congestive cardiomyopathy
- •Electrocardiogram (ECG) with Fridericia's corrected QT interval (QTcF) >500 ms during the screening period
- •Personal or family history of long QT syndrome or sudden cardiac death
- •Left ventricular ejection fraction <45% on historical echocardiogram within 1 year prior to the screening visit
- •Any current or prior history of symptomatic coronary disease (prior myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft surgery, or cardiac anginal chest pain) in the past 6 months prior to the screening visit
- •Cerebrovascular accident within 3 months prior to the screening visit
- •Significant (≥ 2+ regurgitation) mitral regurgitation or aortic regurgitation valvular disease
- •Currently on dialysis or anticipated need for dialysis within the next 12 months
研究组 & 干预措施
Sotatercept
Experimental
Participants on background PAH therapy will be administered sotatercept by SC injection at a starting dose of 0.3 mg/kg, with a target dose of 0.7 mg/kg, every 21 days
干预措施: Sotatercept (Drug)
Placebo
Placebo Comparator
Participants on background PAH therapy will be administered placebo by SC injection every 21 days
干预措施: Placebo (Other)
结局指标
主要结局
Time to First Confirmed Morbidity or Mortality Event
时间窗: Up to approximately 31 months
Morbidity or mortality events were defined as all-cause death, lung transplantation, or PAH worsening-related hospitalization of ≥24 hours. All events were adjudicated by a blinded, independent committee of clinical experts. Only adjudication-confirmed lung transplantation and PAH worsening-related hospitalization of ≥24 hours were included in the primary analysis. All deaths that are a first event for a participant were included regardless of adjudication. The time from randomization to the first confirmed morbidity or mortality event, calculated using the non-parametric Kaplan-Meier method, is presented.
次要结局
- Percentage of Participants Who Experienced a Mortality Event(Up to approximately 31 months)
- Percentage of Participants Achieving a Low or Intermediate (≤7) REVEAL Lite 2 Risk Score at Week 24(Week 24)
- Change From Baseline in Mean Pulmonary Artery Pressure (mPAP) at Week 24(Baseline and Week 24)
- Change From Baseline in Pulmonary Vascular Resistance (PVR)(Baseline and Week 24)
- Change From Baseline in Cardiac Output (CO) at Week 24(Baseline and Week 24)
- Change From Baseline in Mean Pulmonary Artery Pressure (mPAP) at Week 24(Baseline and Week 24)
- Change From Baseline in Pulmonary Vascular Resistance (PVR)(Baseline and Week 24)
- Change From Baseline in Cardiac Output (CO) at Week 24(Baseline and Week 24)
- Change From Baseline in European Quality of Life (EuroQoL)-5 Dimensions-5 Levels (EQ-5D-5L) Index Score at Week 24(Baseline and Week 24)
- Change From Baseline in 6MWD at Week 24(Baseline and Week 24)
- Change From Baseline in REVEAL Lite 2.0 Risk Score at Week 24(Baseline and Week 24)
- Change From Baseline in NT-proBNP Levels at Week 24(Baseline and Week 24)
- Overall Survival (OS)(Up to approximately 31 months)
- Transplant-free Survival(Up to approximately 31 months)
- Percentage of Participants Who Improve in WHO FC(Baseline and up to approximately 31 months)
研究者
研究点 (57)
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- The findings support Winrevair's potential to change the management of PAH, with detailed results to be presented at an upcoming medical meeting.last yearMerck Halts Phase 3 HYPERION Trial of Winrevair Early After Positive ZENITH Results- Merck's Phase 3 HYPERION trial of Winrevair (sotatercept) for pulmonary arterial hypertension (PAH) is stopped early due to positive results from the ZENITH trial.
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