A Multicenter Open Label Study to Evaluate Efficacy and Safety of China Made Ambrisentan in Chinese Patients With Pulmonary Arterial Hypertension
Overview
- Phase
- Phase 3
- Intervention
- Ambrisentan
- Conditions
- Pulmonary Arterial Hypertension
- Sponsor
- RenJi Hospital
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- Change From Baseline to 12 weeks and 24weeks in 6-minute Walk Distance
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
This multicenter, open label, single-arm study is aim at investigating the the efficacy and safety of china made ambrisentan in Chinese subjects with PAH.
Detailed Description
Pulmonary arterial hypertension is a hemodynamic and pathophysiological state, which can cause progressive hyperplasia of pulmonary vascular walls and elevated pulmonary arterial pressure for various reasons. Ambrisentan is a selective endothelin-A (ETA) receptor antagonist with vasodilatory, antiproliferative and vascular remodeling effects at a dose of 5 mg or 10 mg once daily, oral. A number of international clinical studies have shown that ambrisentan can improve the hemodynamic parameters, WHO functional classification and exercise tolerance of PAH patients, and improve the survival rate. The domestic Ambrisentan tablet is produced by Jiangsu Hansoh Pharmaceutical Group Co., Ltd. under the trade name of "Pu Nuo An". It has been developed and completed according to the consistency evaluation standard after the bioequivalence test, and is currently listed in mainland China. In view of the low price of the domestic ambrisentan, in order to verify its efficacy and safety in the real world, this post-marketing multicenter clinical study was carried out.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age ≥18 years old and ≤75 years old, regardless of gender;
- •patients weighing ≥ 40 kg;
- •Patients diagnosed with PAH in Group 1 of the WHO Updated Clinical Classification of Pulmonary Hypertension (WHO functional class II or III);
- •6 min walk test (6MWT), walking distance ≥ 50 m;
- •Right heart catheterization performed within 6 months prior to screening and meeting the following hemodynamic criteria:
- •mean pulmonary artery pressure ≥ 25 mm Hg；
- •Pulmonary vascular resistance ≥ 240 dyn·s·cm-5;
- •Pulmonary artery wedge pressure or left ventricular end-diastolic pressure ≤ 15 mmHg;
- •Subject receiving calcium channel blocker (CCB) drugs, only those whose doses have been stabilized for more than 4 weeks at the time of screening are allowed to be included in the study;
- •Pulmonary function testing performed within 6 months prior to screening and meeting the following criteria：
Exclusion Criteria
- •Patients diagnosed with WHO updated PH clinical classification of group 2, 3, 4, 5;
- •Endothelin receptor antagonist therapy (eg, bosentan) has been discontinued prior to enrollment due to safety or tolerability concerns (non-drug-induced liver function abnormalities);
- •Serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels \> 2 times ULN;
- •Serum bilirubin level \> 1.5 times ULN;
- •severe hepatic insufficiency (Child-Pugh class C);
- •severe renal insufficiency (creatinine clearance \<30 mL/min);
- •Hemoglobin concentration \< 10 g/dL or hematocrit \< 30%;
- •Contraindications to treatment identified by laboratory tests, physical examination, medical history, or other investigations
- •severe hypotension (diastolic \< 50 mm Hg or systolic \< 90 mm Hg);
- •Clinically significant aortic or mitral valve disease, pericardial constriction, restrictive or congestive cardiomyopathy, fatal arrhythmias, LV ejection fraction \< 45%, LV outflow tract obstruction, symptomatic coronary heart disease, spontaneously low blood pressure;
Arms & Interventions
ambrisentan
Open Label
Intervention: Ambrisentan
Outcomes
Primary Outcomes
Change From Baseline to 12 weeks and 24weeks in 6-minute Walk Distance
Time Frame: Baseline, week 12 and week 24
The 6-minute walk test (6MWT) is a non-encouraged test, performed in a 30 m long flat corridor, where the patient is instructed to walk as far as possible, back and forth around two cones, with the permission to slow down, rest, or stop if needed. These guidelines were provided to all sites. For patients who had never performed a 6MWT previously, a training test was required before the qualifying tests for inclusion were performed.
Secondary Outcomes
- Number of participants with a change from baseline to week 12 and 24 in WHO functional class(Baseline, week 12 and week 24)
- Changes from baseline to week 12 and 24 in BNP plasma levels(Baseline, week 12 and week 24)
- Number and severity of Participants With Any Adverse Events(From Baseline to week 24)
- Time to Clinical Worsening of Pulmonary Arterial Hypertension (PAH) up to Week 24, Assessed as the First Occurrence of a Clinical Worsening Events(From Baseline to week 24)
- Change from baseline to week 12 and 24 in Borg Dyspnea Index (BDI) sores(Baseline, week 12 and week 24)