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To Assess The Efficacy and Safety Of Oral Sildenafil in the Treatment of Pulmonary Arterial Hypertension.

Phase 4
Terminated
Conditions
Pulmonary Arterial Hypertension
Interventions
Registration Number
NCT00430716
Lead Sponsor
Pfizer's Upjohn has merged with Mylan to form Viatris Inc.
Brief Summary

To demonstrate a dose response for 1 mg, 5 mg and 20 mg TID oral sildenafil for the treatment of subjects with PAH.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
130
Inclusion Criteria
  • Subjects with PAH (i.e. IPAH or secondary to connective tissue disease or with surgical repair of ASD, VSD, PDA, aorto-pulmonary window) whose baseline six minute walk test distance is >/= 100 m and </= 450 m.
  • Subjects with a mean pulmonary artery pressure of >/= 25 mmHg and a pulmonary artery wedge pressure of </= 15 mmHg at rest via right heart catheterization performed within 12 weeks prior to randomization.
Exclusion Criteria
  • Subjects whose 6 Minute Walk Distance may be limited by conditions other than PAH related dyspnoea or fatigue, e.g. claudication from vascular insufficiency or significant arthritis.
  • Subjects who are currently receiving any forms of chronic treatment for PAH such as prostacyclin, PDE-5 inhibitors, endothelin-receptor antagonists, nitrates or nitric oxide donors (e.g. arginine supplement, nicorandil) in any form, protease inhibitors such as ritonavir and saquinavir, ketoconazole, itraconazole, and alpha blockers. Subjects previously receiving any of these drugs must have stopped use for a period of at least 1 month prior to screening, except in the case of bosentan or prostacyclin (3 months).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sildenafil High doseSildenafil citrate-
Sildenafil Low doseSildenafil citrate-
Sildenafil medium doseSildenafil citrate-
Sildenafil - Open label PhaseSildenafil citrateOpen label extension from week 12 to week 24.
Primary Outcome Measures
NameTimeMethod
Change From Baseline in the Total Distance Walked During 6-Minute Walk Test (6MWT) at Week 12Baseline and Week 12

6 MWT was the distance that a participant could walk in 6 minutes. Participants were asked to perform the test at a pace that was comfortable to them, with as many breaks as they needed. Continuous pulse oximetry was conducted during the test for safety.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Mean Pulmonary Arterial Pressure (mPAP) at Week 12Baseline and Week 12

mPAP was measured using a pressure transducer positioned at the mid-axillary line.

Number of Participants With Clinical WorseningBaseline through Week 12

Clinical worsening was defined as death; or lung transplantation; or hospitalization due to pulmonary hypertension; or initiation of prostacyclin therapy; or initiation of endothelin receptor antagonist therapy. (PAH=pulmonary arterial hypertension) Due to very low number of events of clinical worsening reported, the median days to clinical worsening could not be estimated.

Number of Participants With Change From Baseline in PAH Criteria for Functional Capacity and Therapeutic Class at Week 12Baseline and Week 12

Pulmonary arterial hypertension (PAH) Criteria for WHO Class: Class I (Participants without resulting limitation of physical activity);Class II (Participants with slight limitation of physical activity though comfortable at rest);Class III (Participants with marked limitation of physical activity,though comfortable at rest);Class IV(Participants with inability to carry out any physical activity without symptoms,manifest signs of right heart failure; dyspnoea and/or fatigue may even be present at rest; and discomfort is increased by any physical activity).

Change From Baseline in B-Type Natriuretic Peptide (BNP) at Week 12Baseline and Week 12

BNP is a non-invasive biomarker and an indicator of progression of PAH/ right ventricular dysfunction in participants with PAH.

Change From Baseline in Pro-BNP at Week 12Baseline and Week 12

Pro- BNP which is a precursor of BNP, is a non-invasive biomarker and an indicator of progression of PAH / RV dysfunction in participants with PAH.

Change From Baseline in TAPSE Measurement at Week 12Baseline and Week 12

Tricuspid annular plane systolic excursion (TAPSE) was measured as the total displacement of the tricuspid annulus in cm from end diastole to end systole.TAPSE is an indicator of progression of PAH /right ventricular dysfunction.

The baseline data for 33 participants were measured incorrectly and the results from the 33 participants (both baseline and post-baseline) were excluded from the analysis.

Change From Baseline in BORG Dyspnoea Score at Week 12Baseline and Week 12

BORG dyspnoea scale is a 10-point scale where following scores stands for severity of dyspnoea: 0 (no breathlessness at all); 0.5 (very very slight \[just noticeable\]); 1 (very slight); 2 (slight breathlessness); 3 (moderate); 4 (some what severe); 5 (severe breathlessness); 7 (very severe breathlessness); 9 (very very severe \[almost maximum\] and 10 (maximum).

Trial Locations

Locations (45)

Erasmus MC

🇳🇱

Rotterdam, Netherlands

Hospital São Lucas da PUCRS

🇧🇷

Porto Alegre, RS, Brazil

Care Hospital, The Institute of Medical Sciences

🇮🇳

Hyderabad, Andhra Pradesh, India

Instituto Dante Pazzanese de Cardiologia

🇧🇷

Sao Paulo, SP, Brazil

Norfolk and Norwich University Hospital

🇬🇧

Norwich, Norfolk, United Kingdom

Peta mnogoprofilna bolnitsa za aktivno lechenie, Klinika po kardiologia

🇧🇬

Sofia, Bulgaria

Metro Multispeciality Hospital

🇮🇳

Noida, Uttar Pradesh, India

IRCCS Policlinico San Matteo

🇮🇹

Pavia, Italy

VU Medisch Centrum / afdeling Longziekten

🇳🇱

Amsterdam, Netherlands

Unita' di Ipertensione Polmonare, Dipartimento di Scienze Respiratorie e Cardiovascolari

🇮🇹

Roma, Italy

National Heart Institute

🇲🇾

Kuala Lumpur, Malaysia

Philippine General Hospital

🇵🇭

Manila City, Philippines

Krakowski Szpital Specjalistyczny Im. Jana Pawla II w Krakowie

🇵🇱

Krakow, Poland

Samodzielny Publiczny Zaklad Opieki Zdrowotnej, Slaskie Centrum Chorob Serca

🇵🇱

Zabrze, Poland

Department of Medicine,

🇹🇭

Bangkok, Thailand

Philippine Heart Center

🇵🇭

Quezon City, Philippines

Spitalul Clinic de Boli Infectioase si Pneumoftiziologie Dr. Victor Babes

🇷🇴

Timisoara, Timis, Romania

Spitalul Clinic de Pneumoftiziologie

🇷🇴

Iasi, Romania

Scientific Center of Cardiovascular surgery n.a. A.N.Bakoulev RAMS

🇷🇺

Moscow, Russian Federation

Atlanta Institute for Medical Research, Inc.

🇺🇸

Decatur, Georgia, United States

The University of North Carolina at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

Pulmonary Associates of Richmond, Inc.

🇺🇸

Richmond, Virginia, United States

Mnogoprofilna bolnitsa za aktivno lechenie i speshna meditsina "N.I.Pirogov"

🇧🇬

Sofia, Bulgaria

St. John's Medical College Hospital

🇮🇳

Bangalore, Karnataka, India

P. Stradins Clinical University Hospital / Latvian Centre of Cardilogy

🇱🇻

Riga, Latvia

The Care Group, LLC

🇺🇸

Indianapolis, Indiana, United States

Baylor College of Medicine Pulmonary Section

🇺🇸

Houston, Texas, United States

St. Luke's Episcopal Hospital

🇺🇸

Houston, Texas, United States

Medical College of Georgia

🇺🇸

Augusta, Georgia, United States

University of Utah Sciences Center

🇺🇸

Salt Lake City, Utah, United States

Arizona Pulmonary Specialists, LTD

🇺🇸

Phoenix, Arizona, United States

Mehta Hospital & Cardiopulmonary Care Center

🇮🇳

Ahmedabad, Gujarat, India

Bankers Heart Institute

🇮🇳

Vadodara, Gujarat, India

Attikon Hospital

🇬🇷

Haidari, Athens, Greece

Universitaire Ziekenhuizen Leuven - Campus Gasthuisberg

🇧🇪

Leuven, Belgium

Shanghai Pulmonology Hospital

🇨🇳

Shanghai, China

Beijing Shijitan Hospital

🇨🇳

Beijing, China

Room 224A Sir William Leech Centre

🇬🇧

Newcastle Upon Tyne, Tyne and Wear, United Kingdom

CJW Chippenham Medical Center

🇺🇸

Richmond, Virginia, United States

Division of Rheumatology Allergy and Immunology, Department of Medicine, Faculty of Medicine

🇹🇭

Amphoe Mueang, Khon Kaen, Thailand

Presbyterian Hospital

🇺🇸

Charlotte, North Carolina, United States

Mid Carolina Cardiology

🇺🇸

Charlotte, North Carolina, United States

Chicago Heart Institute

🇺🇸

Elk Grove Village, Illinois, United States

Virginia Cardiovascular Specialists

🇺🇸

Richmond, Virginia, United States

Cardiovascular Associates of Virginia

🇺🇸

Richmond, Virginia, United States

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