Study of Efficacy and Safety of LTP001 in Pulmonary Arterial Hypertension

Phase 2

Terminated

• Conditions: Pulmonary Arterial Hypertension
• Interventions: Drug: LTP001; Drug: Placebo

• Registration Number: NCT05135000
• Lead Sponsor: Novartis Pharmaceuticals

Brief Summary

The purpose of this study is to explore the efficacy and safety of LTP001 in participants with pulmonary arterial hypertension (PAH) to determine if LTP001 has an adequate clinical profile to warrant further clinical development in this indication.

Detailed Description

This is a non-confirmatory, randomized, subject- and investigator-blinded, placebo controlled study of LTP001 in PAH participants. Approximately 44 male and female adults with PAH participants will be randomized in a 3:1 ratio of LTP001 active dose to placebo. Participants will be screened for up to 8 weeks followed by 24 weeks of daily dosing with visits approximately every 4 weeks. One follow up visit will also be the end of study visit and occurs approximately 30 days after the end of treatment. Total study duration is approximately 37 weeks from start of screening to end of study visit. If a participant continues into the open-label extension study, then the follow-up visit may be skipped.

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study First Submitted: 2021-11-16
• Study First Submitted QC: 2021-11-16
• Study First Posted: 2021-11-26
• Study Start: 2022-06-30
• Primary Completion: 2024-03-20
• Study Completion: 2024-04-25
• Status Verified: 2024-08
• Last Update Submitted: 2024-08-05
• Last Update Posted: 2024-08-06

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 47

Inclusion Criteria

• History of PAH belonging to one of the following subgroups of the Clinical Classification Group 1 (WHO):

  • participants with idiopathic pulmonary arterial hypertension (IPAH)
  • Hereditary pulmonary arterial hypertension
  • Congenital heart disease (surgically repaired at least 12 months prior to screening)
  • drug or toxin induced (for example, anorexigen, or methamphetamine use).

• Resting mean pulmonary arterial pressure (mPAP) > 25 mmHg; pulmonary capillary wedge pressure (PCWP) or left ventricular end diastolic pressure < 15 mmHg, as determined by right heart catheterization within 20 days of randomization.

• Pulmonary Vascular Resistance > 6 Wood units (480 dynes s/cm-5), as determined by right heart catheterization within 20 days of randomization.

• WHO Functional Class II-III

• 6MWD must be between 150 and 550 m (inclusive). The qualifying test needs to be within 20 days of randomization. To meet the above criterion additional six minute walk test (6MWT) may be performed up to a maximum of 3 tests in total prior to dosing; the minimal time difference between two tests should be at least 4 h.

  • Standard of care therapy which is stable at least 6 weeks prior to RHC and qualifying 6MWT assessment within 20 days of randomization. Standard of care includes one or more of the following treatments:
  • prostacyclin analogues and receptor agonists (if I.V., dose adjustments must be within 20% of initial stable dose)
  • endothelin receptor antagonists (ERAs)
  • phosphodiesterase type 5 inhibitors (PDE5i)
  • soluble guanylate cyclase (sGC) stimulators

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Exclusion Criteria

• Participants with pulmonary hypertension (PH) in the Clinical Classification Groups 2-5 (WHO), and any PAH Group 1 subgroups not covered by Inclusion Criterion #4.
• Participants with a history of left sided heart disease, chronic left sided heart failure, congenital or acquired valvular disease compromising left ventricular function and/or pulmonary venous hypertension or symptomatic coronary disease (non-symptomatic, revascularized coronary artery disease would be acceptable).
• Participants with obstructive lung disease defined as: FEV1/FVC < 60% and FEV1 < 60% of predicted value after bronchodilator administration as well as participants with moderate or severe restrictive lung disease: Total Lung Capacity < 70% of predicted value. Testing must have occurred within 24months of screening. If historical testing is not available, then lung function testing must be conducted during the screening period.
• Acute or chronic impairment (other than dyspnea), which would limit the ability to comply with study requirements, including interference with physical activity and execution of study procedures such as 6MWT (e.g., angina pectoris, claudication, musculoskeletal disorder, multiple sclerosis, need for walking aids).

Additional protocol-defined inclusion / exclusion criteria may apply.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
LTP001	LTP001	Participants will receive LTP001 orally once daily in the morning for approximately 24 weeks
Placebo	Placebo	Participants will receive LTP001 placebo capsules matching LTP001 orally once daily in the morning for approximately 24 weeks

Primary Outcome Measures

Name	Time	Method
Change from baseline right heard catheterization Pulmonary vascular resistance (PVR) at week 25	Baseline, week 25	PVR defined as the resistance against blood flow from the pulmonary artery to the left atrium measured in dyn.s.cm-5

Secondary Outcome Measures

Name	Time	Method
Change from baseline in Six Minute Walk Distance (6MWD)	Baseline, weeks 13 and 25	6MWD test measures the distance that a patient can quickly walk on a flat, hard surface in a period of 6 minutes
Change from baseline in Right Ventricle (RV) pressures at week 25	Baseline, Week 25	The Right Heart Catheterization (RHC) assessment is performed to assess several hemodynamic variables in pulmonary hypertension, including RV pressures.
Change from baseline in pulmonary capillary wedge pressure at week 25	Baseline, Week 25	The Right Heart Catheterization (RHC) assessment is performed to assess several hemodynamic variables in pulmonary hypertension, including pulmonary capillary wedge pressure (PCWP).
Change from baseline in pulmonary artery pressures at week 25	Baseline, Week 25	The Right Heart Catheterization (RHC) assessment is performed to assess several hemodynamic variables in pulmonary hypertension, including pulmonary artery pressure.
Change from baseline in Cardiac Output (CO) at week 25	Baseline, Week 25	The Right Heart Catheterization (RHC) assessment was performed to assess several hemodynamic variables in pulmonary hypertension, including Cardiac Output (CO).
Change from baseline in tricuspid annular plane systolic excursion (TAPSE)	Baseline, weeks 5, 13 and 25	Key Right Ventricular (RV) function endpoints such as Tricuspid Annular Plane Sys Excursion (TAPSE) are to be assessed with echocardiography.
Change from baseline in tricuspid annular systolic velocity (TASV)	Baseline, weeks 5, 13 and 25	Key Right Ventricular (RV) function endpoints such as tricuspid annular systolic velocity (TASV) are to be assessed with echocardiography.
Change from baseline of peak velocity of excursion (RV S')	Baseline, weeks 5, 13 and 25	Key Right Ventricular (RV) function endpoints such as peak velocity of excursion (RV S') are to be assessed with echocardiography.
Change from baseline in fractional area change (FAC)	Baseline, weeks 5, 13 and 25	Key Right Ventricular (RV) function endpoints such as RV fractional area change (RV FAC) are to be assessed with echocardiography.
Change from baseline in EmPHasis-10	Baseline, weeks 13 and 25	emPHasis-10 is a questionnaire with 10 questions and is designed to determine how pulmonary hypertension affects a participant's life.
Change from baseline in PAH-SYMPACT	Baseline, weeks 13 and 25	PAH-SYMPACT is a questionnaire used to assess pulmonary arterial hypertension symptoms and their impact.
Maximum Observed Blood Concentrations (Cmax) for LTP001	Day 1 and Week 25	The maximum (peak) observed blood drug concentration after single dose administration (ng x mL-1)
Time to Reach Maximum Blood Concentrations (Tmax) of LTP001	Day 1 and Week 25	The time to reach maximum (peak) blood drug concentration after single dose administration (h)
Time to Clinical Worsening	Baseline to Week 29	Time to any of the following: * Death; * Hospital stay greater than 24 hours due to worsening of pulmonary arterial hypertension; * Worsening of PAH resulting in need for lung transplantation or balloon atrial septostomy; * Initiation of parenteral prostanoid therapy, initiation of oxygen therapy, initiation of any other pulmonary arterial hypertension-specific therapies or need for increase of diuretics for more than 4 weeks due to worsening of pulmonary arterial hypertension; * Disease progression; * Significant drop in six minute walk distance
Change from baseline in N-terminal fragment of the prohormone B-type natriuetic peptide (NT-ProBNP)	Baseline to Week 29	NT-proBNP is a blood biomarker to assess right ventricular distress.

Trial Locations

Locations (3)

Novartis Investigative Site; 🇬🇧 London, United Kingdom

Pulmonary Associates PA; 🇺🇸 Mesa, Arizona, United States

Medical University of South Carolina; 🇺🇸 Charleston, South Carolina, United States