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Single Dose Study in Patients With Chronic Obstructive Pulmonary Disease (COPD) Associated Pulmonary Hypertension.

Phase 1
Completed
Conditions
Hypertension, Pulmonary
Pulmonary Disease, Chronic Obstructive
Interventions
Registration Number
NCT00640315
Lead Sponsor
Bayer
Brief Summary

This study is to demonstrate the safety, tolerability, pharmakokinetic and pharmacodynamic effect of a single oral dose of BAY63-2521 in patients with pulmonary hypertension due to chronic obstructive pulmonary disease (COPD).

Detailed Description

In addition to the pharmacodynamic and pharmacokinetic variables, the following laboratory variables were assessed:

* Hematology: Leucocytes, erythrocytes, hemoglobin, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), platelets, white blood cell (WBC), partial thromboplastin time (PTT), prothrombin time (Quick), international normalized ratio (INR) (prothrombin time expressed in relation to normal value) ;

* Clinical chemistry: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (AP), gamma glutamyl transpeptidase (GGT), creatine phosphokinase (CK), lipase, cholinesterase (CHE), glucose, creatinine, urea, uric acid, bilirubin, total protein, serum albumin, sodium, potassium, calcium, chloride.

And due to the small number of subjects analyzed at several local labs, no summary statistics were provided.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
23
Inclusion Criteria
  • Patients with pulmonary hypertension due to COPD, undergoing routine invasive measurement of hemodynamic parameters.
  • Catheters for measurement of hemodynamic parameters (PAP [pulmonary artery pressure], PCWP [pulmonary capillary wedge pressure], CO [cardiac output], SBP [systolic blood pressure]) must be in place independent of the trial.
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Exclusion Criteria
  • Acute exacerbation of COPD,
  • Pre-existing lung disease other than COPD,
  • Acute or severe chronic left heart failure,
  • Severe coronary artery disease,
  • Uncontrolled arterial hypertension;
  • Severe left ventricular hypertrophy,
  • Congenital or acquired valvular or myocardial disease,
  • Systolic blood pressure < 100 mmHg,
  • Heart rate < 55 bpm or >105 bpm,
  • PaO2 (arterial partial oxygen pressure)/FiO2 (fraction of inspired oxygen) < 50 mmHg,
  • PaCO2 (arterial partial pressure of carbon dioxide) > 55 mmHg,
  • Severe hepatic insufficiency,
  • Severe renal insufficiency.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Riociguat (Adempas, BAY63-2521) 1.0 mgRiociguat (Adempas, BAY63-2521) 1.0 mgParticipants received two single oral doses of 1.0 mg riociguat on study day 1 and study day 3.
Riociguat (Adempas, BAY63-2521) 2.5 mgRiociguat (Adempas, BAY63-2521) 2.5 mgParticipants received two single oral doses of 2.5 mg riociguat on study day 1 and study day 3.
Primary Outcome Measures
NameTimeMethod
Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Mean Pulmonary Artery Pressure (PAPmean)From baseline up to 4 hours after administration

PAPmean was reported during right heart catheterization

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Pulmonary Vascular Resistance (PVR)From baseline up to 4 hours after administration

PVR was calculated according to the formula PVR = 80\*(PAPmean - pulmonary capillary wedge pressure)/cardiac output

Area Under the Plasma Concentration Versus Time Curve From Zero to Infinity (AUC) of Riociguat and Metabolite M1 After Single Dose of RiociguatStudy day 1: 0, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 36 hours post-dose; Study day 3: 0, 2, 6, 12, 24 hours post-dose
Area Under the Plasma Concentration Versus Time Curve From Zero to Infinity Divided by Dose (AUC/D) of Riociguat and Metabolite M1 After Single Dose of RiociguatStudy day 1: 0, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 36 hours post-dose; Study day 3: 0, 2, 6, 12, 24 hours post-dose
Area Under the Plasma Concentration Versus Time Curve From Zero to Infinity Divided by Dose Per kg Body Weight (AUCnorm) of Riociguat and Metabolite M1 After Single Dose of RiociguatStudy day 1: 0, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 36 hours post-dose; Study day 3: 0, 2, 6, 12, 24 hours post-dose
Maximum Drug Concentration in Plasma (Cmax) of Riociguat and Metabolite M1 After Single Dose of RiociguatStudy day 1: 0, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 36 hours post-dose; Study day 3: 0, 2, 6, 12, 24 hours post-dose
Maximum Drug Concentration in Plasma Divided by Dose Per kg Body Weight (Cmax,Norm) of Riociguat and Metabolite M1 After Single Dose of RiociguatStudy day 1: 0, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 36 hours post-dose; Study day 3: 0, 2, 6, 12, 24 hours post-dose
Maximum Drug Concentration in Plasma Divided by Dose (Cmax/D) of Riociguat and Metabolite M1 After Single Dose of RiociguatStudy day 1: 0, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 36 hours post-dose; Study day 3: 0, 2, 6, 12, 24 hours post-dose
Secondary Outcome Measures
NameTimeMethod
Multiple Inert Gas Elimination Technique (MIGET) Analysis - Change From Baseline at 1 Hour Post Dose of Low V/Q PerfusionBaseline and 1 hour post dose
Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Mean Arterial Pressure (MAP)From baseline up to 4 hours after administration

MAP was acquired during right heart catheterization

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Mean Right Atrial Pressure (RAPmean)From baseline up to 4 hours after administration

RAPmean was reported during right heart catheterization

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Systolic Pulmonary Artery Pressure (PAPsyst)From baseline up to 4 hours after administration

PAPsyst was acquired during right heart catheterization

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Diastolic Pulmonary Artery Pressure (PAPdiast)From baseline up to 4 hours after administration

PAPdiast was acquired during right heart catheterization

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Pulmonary Capillary Wedge Pressure (PCWP)From baseline up to 4 hours after administration

PCWP was acquired during right heart catheterization

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Heart Rate (HR)From baseline up to 4 hours after administration

HR was acquired during right heart catheterization

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Systolic Blood Pressure (SBP)From baseline up to 4 hours after administration

Systolic arterial blood pressure was acquired during right heart catheterization.

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Diastolic Blood Pressure (DBP)From baseline up to 4 hours after administration

Diastolic arterial blood pressure was acquired during right heart catheterization.

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Cardiac Output (CO)From baseline up to 4 hours after administration

CO was measured in triplicate by the thermodilution technique

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Pulmonary Vascular Resistance Index (PVRI)From baseline up to 4 hours after administration

PVRI was calculated as PVRI = (80\*(PAPmean - PCWP)/CO)\*body surface area

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Systemic Vascular Resistance (SVR)From baseline up to 4 hours after administration

SVR was calculated as SVR = 80\*(MAP-RAPmean)/CO

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Systemic Vascular Resistance Index (SVRI)From baseline up to 4 hours after administration

SVRI was calculated as SVRI = (80\*(MAP - RAPmean)/CO)\*body surface area

Swan-Ganz Hemodynamics - Maximal Change From Baseline at Day 1 of Cardiac IndexFrom baseline up to 4 hours after administration

Cardiac index was calculated as cardiac index = CO / body surface area.

Blood Gas Analysis - Percentage Change From Baseline at 2 Hours Post Dose of Arterial Partial Oxygen Pressure (PaO2)Baseline and 2 hours post dose

Arterial blood gas analysis was performed by insertion of an indwelling arterial cannula. Percent change was calculated as "100%\*(value post dose - value at baseline)/ value at baseline".

Blood Gas Analysis - Percentage Change From Baseline at 2 Hours Post Dose of Arterial Partial Pressure of Carbon Dioxide (PaCO2)Baseline and 2 hours post dose

Arterial blood gas analysis was performed by insertion of an indwelling arterial cannula. Percent change was calculated as "100%\*(value post dose - value at baseline)/ value at baseline".

Blood Gas Analysis - Percentage Change From Baseline at 2 Hours Post Dose of Venous Oxygen Pressure (PvO2)Baseline and 2 hours post dose

Percent change was calculated as "100%\*(value post dose - value at baseline)/ value at baseline".

Blood Gas Analysis - Percentage Change From Baseline at 2 Hours Post Dose of Arterial Oxygen Saturation (SaO2)Baseline and 2 hours post dose

Arterial blood gas analysis was performed by insertion of an indwelling arterial cannula. Percent change was calculated as "100%\*(value post dose - value at baseline)/ value at baseline".

Blood Gas Analysis - Percentage Change From Baseline at 2 Hours Post Dose of Venous Oxygen Saturation (SvO2)Baseline and 2 hours post dose

Percent change was calculated as "100%\*(value post dose - value at baseline)/ value at baseline".

Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Forced Expiratory Volume in 1 Second (FEV1)Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Percent of Predicted FEV1Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Forced Vital Capacity (FVC)Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Percent of Predicted FVCBaseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of FEV1/FVCBaseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Total Lung Capacity (TLC)Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Percent of Predicted TLCBaseline and 2 hours post dose

The percent of predicted TLC was provided by investigator at site.

Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Residual Volume (RV)Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Percent of Predicted RVBaseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Maximal Expiratory Flow at 75% of Expiratory Vital Capacity (MEF75)Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Maximal Expiratory Flow at 50% of Expiratory Vital Capacity (MEF50)Baseline and 2 hours post dose
Multiple Inert Gas Elimination Technique (MIGET) Analysis - Change From Baseline at 1 Hour Post Dose of Dead Space VentilationBaseline and 1 hour post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Maximal Expiratory Flow at 25% of Expiratory Vital Capacity (MEF25)Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Total Airway Resistance (Raw)Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Vital Capacity (VC)Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Percent of Predicted VCBaseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Diffusing Capacity of the Lung for Carbon Monoxide (DLCO)Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Total Lung Capacity at the Time When the DLCO is Measured (Alveolar Volume, VA)Baseline and 2 hours post dose
Lung Function - Percentage Change From Baseline at 2 Hours Post Dose of Specific Diffusing CapacityBaseline and 2 hours post dose
Multiple Inert Gas Elimination Technique (MIGET) Analysis - Change From Baseline at 1 Hour Post Dose of Total Ventilation (V)Baseline and 1 hour post dose
Multiple Inert Gas Elimination Technique (MIGET) Analysis - Change From Baseline at 1 Hour Post Dose of Total Perfusion (Q)Baseline and 1 hour post dose
Multiple Inert Gas Elimination Technique (MIGET) Analysis - Change From Baseline at 1 Hour Post Dose of Normal V/Q PerfusionBaseline and 1 hour post dose
Area Under the Plasma Concentration Verse Time Curve From Zero to the Last Data Point (AUC0-tn) of Riociguat and Metabolite M1 After Single Dose of RiociguatStudy day 1: 0, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 36 hours post-dose; Study day 3: 0, 2, 6, 12, 24 hours post-dose
Multiple Inert Gas Elimination Technique (MIGET) Analysis - Change From Baseline at 1 Hours Post Dose of Ventilation-perfusion Distribution Presented as Standard Deviation (SD) of PerfusionBaseline and 1 hour post dose
Multiple Inert Gas Elimination Technique (MIGET) Analysis - Change From Baseline at 1 Hour Post Dose of Ventilation-perfusion Distribution Presented as Standard Deviation (SD) of VentilationBaseline and 1 hour post dose
Multiple Inert Gas Elimination Technique (MIGET) Analysis - Change From Baseline at 1 Hour Post Dose of Intrapulmonary Shunt FlowBaseline and 1 hour post dose
Time to Reach Maximum Drug Concentration in Plasma (Tmax) of Riociguat and Metabolite M1 After Single Dose of RiociguatStudy day 1: 0, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 36 hours post-dose; Study day 3: 0, 2, 6, 12, 24 hours post-dose
Half-life Associated With the Terminal Slope (t1/2) of Riociguat and Metabolite M1 After Single Dose of RiociguatStudy day 1: 0, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 36 hours post-dose; Study day 3: 0, 2, 6, 12, 24 hours post-dose
Mean Residence Time (MRT) of Riociguat and Metabolite M1 After Single Dose of RiociguatStudy day 1: 0, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 36 hours post-dose; Study day 3: 0, 2, 6, 12, 24 hours post-dose
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