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Pulmonary Arterial HypertensionPhase 2NCT00989963

Dose-response Study of the Safety and Efficacy of Beraprost Sodium Modified Release (BPS-MR) in Patients With Pulmonary Arterial Hypertension (PAH)

A Phase 2 study testing Beraprost Sodium Modified Release in people with Pulmonary Arterial Hypertension, run by Lung Biotechnology PBC at 17 sites in 6 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a 12-week, international, multicenter, double-blind, three-group, dose-response study to assess the safety and efficacy of BPS-MR in patients with PAH. Eligible patients will have been previously diagnosed with PAH and will be on a stable course of an ERA and/or PDE-5 inhibitor for at least 60 days prior to… Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Pulmonary Arterial Hypertension
What is being tested?
Beraprost Sodium Modified Release
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
36 participants
Where
17 sitesin 6 countries
Study dates
1 Feb 2010to 13 Sep 2011
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • IRB approved written informed consent has been obtained.
  • Male or female, age 18 to 75 years (inclusive).
  • Established diagnosis of pulmonary arterial hypertension that is either idiopathic or familial PAH, collagen vascular disease associated PAH, PAH induced by anorexigens, or PAH associated with repaired congenital systemic-to-pulmonary shunts (repaired ≥5 years).
  • Clinically stable PAH as determined by the Investigator.
  • Able to walk unassisted.
  • Has a complete, unencouraged 6MWT distance of 150 to 450 meters (inclusive) at Screening.
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  • Previous (at any time) right heart cardiac catheterization with findings consistent with PAH, specifically mean Pulmonary Arterial Pressure (PAPm) ≥25 mmHg (at rest), Pulmonary Capillary Wedge Pressure (PCWP) (or left ventricular end diastolic pressure) ≤15 mmHg, and Pulmonary Vascular Resistance (PVR) >3 mmHg/L/min.
  • Previous (at any time) chest radiograph consistent with the diagnosis of PAH.
  • Has been on a stable course of an ERA or/and PDE-5 inhibitor for a minimum of 60 days prior to Baseline.
  • Women of child-bearing potential (defined as less than 1 year post-menopausal or not surgically sterile) must be using an acceptable method of birth control or practicing abstinence. If sexually active, female patients must use a double barrier method of birth control, such as a condom and spermicidal. Patient must have a negative pregnancy test at the Screening and Baseline visits.
  • Willing and able to comply with study requirements and restrictions.

Who cannot join

  • Has pulmonary venous hypertension, pulmonary veno-occlusive disease, pulmonary capillary hemangiomatosis, or chronic thromboembolic pulmonary hypertension.
  • Has a history of interstitial lung disease, unless:
  • Pulmonary Function Testing conducted within 6 months of the Baseline visit demonstrates a Total Lung Capacity ≥ 70 % of predicted.
  • Has a history of obstructive lung disease, unless:
  • Pulmonary Function Testing conducted within 6 months of the Baseline visit demonstrates a forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio of ≥ 50%.
  • Is pregnant and/or lactating.
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  • Changed or discontinued any PAH medication within 60 days prior to the Baseline visit including, but not limited to, an ERA, PDE-5 inhibitor, or calcium channel blocker (with the exception of anticoagulants).
  • Has an ongoing hemorrhagic condition (e.g. upper digestive tract hemorrhage, hemoptysis, etc), or has a pre-existing condition that, in the Investigator's judgment may increase the risk for developing hemorrhage during the study (e.g. hemophilia). Transient hemorrhage (e.g. epistaxis, normal menstrual bleeding, gingival bleeding, hemorrhoidal hemorrhage, etc.) will not preclude enrollment.
  • Has donated blood or plasma, or has lost a volume of blood >450mL within 6-weeks of the Baseline visit.
  • Has received any investigational medication, device or therapy within 30 days prior to the Baseline visit or is scheduled to receive another investigational drug, device or therapy during the course of the study.
  • Has received any prostanoid therapy at any time.
  • Has any preexisting disease known to cause pulmonary hypertension other than collagen vascular disease.
  • Has any musculoskeletal disease or any other disease that would limit ambulation.
  • Has any form of unrepaired or recently repaired (< 5 years) congenital systemic-to-pulmonary shunt other than patent foramen ovale.
  • History of pulmonary embolism or deep venous thrombosis.
  • History of ischemic heart disease, including previous myocardial infarction, or symptomatic coronary artery disease, or history of left sided myocardial disease as evidenced by a mean PCWP (or a left ventricular end diastolic pressure) > 15 mmHg or left ventricular ejection fraction < 40% as assessed by either multigated angiogram, angiography or echocardiography, or left ventricular shortening fraction < 22% as assessed by echocardiography. Note that patients in whom abnormal left ventricular function is attributed entirely to impaired left ventricular filling due to the effects of right ventricular overload (i.e. right ventricular hypertrophy and/or dilatation) will not be excluded.
  • Presence of atrial fibrillation (determined from 12-lead ECG at Screening).
  • Any other clinically significant illness that, in the opinion of the Investigator, might put the patient at risk of harm during the study or might adversely affect the interpretation of the study data.

Trial locations and contacts

17 sites in 6 countries.

17 sites in 6 countries

United States6 sites
  • UT Southwestern Medical Center

    Dallas, Texas, 75390

  • Edward Heart Hospital

    Naperville, Illinois, 60566

  • Beth Israel Medical Center

    New York, New York, 10003

  • Allegheny General Hospital

    Pittsburgh, Pennsylvania, 15212

  • Albert Einstein College of Medicine

    The Bronx, New York, 10461

  • Harbor-UCLA Medical Center

    Torrance, California, 90502

Other trials in United States

Germany4 sites
  • Klinikum der Universitat zu Koln

    Cologne, 50937

  • Medizinische Klinik und Poliklinik

    Dresden, 01307

  • Abt. Innere Medizin III, Medizinische Universitatsklinik

    Heidelberg, 69120

  • Universitatsklinik Leipzig Abteilung Pulmologie

    Leipzig, 04103

Other trials in Germany

Romania3 sites
  • Institutul de Urgenta pentru Boli

    Bucharest, 022322

  • Institutul National de Pneumologie

    Bucharest, 050159

  • Institutul de Boli Cardiovasculare

    Lasi, 700503

Other trials in Romania

Belgium2 sites
  • Universite Libre de Bruxelles

    Bruxellas, 1070

  • Catholic University of Leuven

    Leuven, 3000

Other trials in Belgium

Czechia1 site
  • General Teaching Hospital

    Prague, 2, 128 08

Other trials in Czechia

Ireland1 site
  • Mater Misericordiae University Hospital Ltd.

    Dublin, 7

Other trials in Ireland

About this study

Official title: A 12-week, Double-blind, International, Multicenter, Dose-response Study of the Safety and Efficacy of Beraprost Sodium Modified Release (BPS-MR) in Patients With Pulmonary Arterial Hypertension (PAH)

This is a 12-week, international, multicenter, double-blind, three-group, dose-response study to assess the safety and efficacy of BPS-MR in patients with PAH. Eligible patients will have been previously diagnosed with PAH and will be on a stable course of an ERA and/or PDE-5 inhibitor for at least 60 days prior to Baseline.

Patients will be randomized to 1 of 3 treatment groups in a 1:1:1 ratio and will be stratified by PAH background therapy (Endothelium Receptor Antagonist (ERA), Phosphodiesterase-5 (PDE-5), and both). The treatment groups consist of one Maximum Tolerated Dose (MTD) and two Fixed Dose (FD) groups. Following randomization, patients will begin taking active drug (60µg) orally twice daily. Patients will visit their investigational site at Week 6 and Week 12 for study evaluations.

Read the detailed description

This is a 12-week, international, multicenter, double-blind, three-group, dose-response study to assess the safety and efficacy of BPS-MR in patients with PAH. Eligible patients will have been previously diagnosed with PAH and will be on a stable course of an ERA and/or PDE-5 inhibitor for at least 60 days prior to Baseline.

A total of approximately 36 patients will be randomized to 1 of 3 treatment groups (12 per group) in a 1:1:1 ratio and will be stratified by PAH background therapy (ERA, PDE-5, and both). The treatment groups consist of one MTD and two FD groups. Following randomization, patients will begin taking active drug (60µg) orally twice daily. Patients will visit their investigational site at Week 6 and Week 12 for study evaluations. Between visits, clinical site personnel will contact patients by phone each week to assess tolerability, provide instructions for a change in dosage, record changes in concomitant medications, and record adverse events. Patients who complete the study will be offered the opportunity to continue taking study medication in a separate open-label continuation protocol. Patients who withdraw early from the study or who otherwise do not elect to enroll into the open-label continuation protocol will be down-titrated off of BPS-MR at the discretion of the Investigator, at a maximum decrement not to exceed one tablet (60µg) b.i.d. per day and a minimum decrement of one tablet (60µg) b.i.d. per week.

Patients in the iMTD treatment group will dose escalate weekly by 60µg b.i.d. until they reach the maximum dose of 600µg b.i.d. or they reach an intolerable dose which requires them to down-titrate by 60µg b.i.d. In these instances and at the Investigator's discretion, further attempts at dose escalation may be made.

The FD treatment groups will consist of a low dose group receiving 60µg b.i.d. and a high dose group receiving 240µg b.i.d. Patients in the high dose group will dose escalate weekly by 60µg b.i.d. until they reach the fixed dose of 240µg b.i.d. Once patients in these treatment groups have reached their assigned maximum dose of active drug, weekly increases in the number of placebo tablets administered will continue in order to maintain the blind.

Patients will be requested to maintain a daily diary of symptoms and study drug administration for evaluation by clinical site personnel. Also, patients will be given the option to contribute blood for pharmacokinetic assessment of BPS/BPS-314d plasma concentrations at the Week 12 visit.

Being tested
Beraprost Sodium Modified Release
Keywords
PAH
Medical subject headings
Pulmonary Arterial Hypertension

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Beraprost Sodium Modified ReleaseDrug

    60µg Tablets, twice a day for 12 weeks

Study groups in NCT00989963
Study groupRoleWhat they receive
Maximum Tolerated Dose (MTD)ExperimentalPatients in the MTD treatment group will dose escalate weekly by 60µg b.i.d. until they reach the maximum dose of 600µg b.i.d. or they reach an intolerable dose which requires them to down-titrate by 60µg b.i.d. In these instances and at the Investigator's discretion, further attempts at dose escalation may be made.
Receives: Drug: Beraprost Sodium Modified Release
Low Fixed DoseExperimentalThe low dose group will receive 60µg twice a day(b.i.d.)
Receives: Drug: Beraprost Sodium Modified Release
High Fixed DoseExperimentalPatients in the high dose group will dose escalate weekly by 60µg twice a day (b.i.d.) until they reach the fixed dose of 240µg b.i.d. Once patients in these treatment groups have reached their assigned maximum dose of active drug,
Receives: Drug: Beraprost Sodium Modified Release

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline in Pulmonary Vascular Resistance at Week 12

    The change in Pulmonary Vascular Resistance (PVR) was evaluated from Baseline to Week 12. PVR is expressed in Wood Units or millimeters of Mercury per Liter per minute (mmHG/L/min)

    Measured: Week 12

  2. Change From Baseline in Cardiac Output (CO) at Week 12

    The change in Cardiac Output was evaluated from Baseline to Week 12.

    Measured: Week 12

  3. Change From Baseline in Pulmonary Arterial Pressure at Week 12

    The change in mean Pulmonary Arterial Pressure (mPAP) was evaluated from Baseline to Week 12.

    Measured: 12 weeks

Secondary outcomes (6)
  1. Change in Six Minute Walk Distance From Baseline to Week 6 and Week 12

    Area used for the Six Minute Walk Test (6MWT) was pre-measured at 30 meters in length. Rest periods were allowed if patient could no longer continue. If patient needed to rest, he/she could stand or sit and then begin again when rested but the clock continued to run. At the end of 6 minutes, the tester called "stop" while stopping the watch and then measured the distance walked. For purposes of the 6MWT, if patient was assessed at Baseline using oxygen therapy, all future 6MWT were conducted in the same manner. All efficacy results are descriptive; no statistical analysis was conducted.

    Measured: Baseline, Week 6 and 12

  2. Number of Participants in Each World Health Organization (WHO) Functional Class for Pulmonary Arterial Hypertension (PAH) at Week 6 and 12

    WHO functional classification for PAH range from Class I (no limitation in physical activity, no dyspnea with normal activity), Class II (slight limitation of physical activity), Class III (marked limitation of physical activity) and Class IV (cannot perform a physical activity without any symptoms, dyspnea at rest).

    Measured: Week 6 and Week 12

  3. Number of Participants With at Least One Post-baseline Clinically Significant Laboratory Value

    Post-baseline clinically significant values, as defined by the Investigator, for hematology, serum chemistry, coagulation and urinalysis parameters were summarized.

    Measured: Up to Week 12

  4. Number of Participants With Newly Occurring Clinically Significant ECG Abnormalities

    Clinically significant ECG abnormalities at Baseline only are excluded.

    Measured: Up to 12 weeks

  5. Change in Borg Dyspnea Score From Baseline to Week 6 and Week 12

    The modified 0-10 category-ratio Borg scale consists of an 11-point scale rating the maximum level of dyspnea experienced during the 6MWT. Scores range from 0 (for the best condition) and 10 (for the worst condition) with nonlinear spacing of verbal descriptors of severity corresponding to specific numbers. The participant chose the number or the verbal descriptor to reflect presumed ratio properties of sensation or symptom intensity. Only participants with both a measurement at baseline and at the given visit are presented. All efficacy results are descriptive; no statistical analysis was conducted.

    Measured: Baseline, Week 6 and 12

  6. N-Terminal ProB-type Natriuretic Peptide Level at Week 6 and Week 12

    NT-proBNP functions as a strong indicator of prognosis in patients with pulmonary arterial hypertension.

    Measured: Week 6 and Week 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Oct 2009 (estimated)
  2. Study start1 Feb 2010
  3. Primary completion13 Sep 2011
  4. Study completion13 Sep 2011

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
36 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00989963
Sponsor's protocol ID
BPS-MR-PAH-203
Status last verified
Sep 2020
First submitted
5 Oct 2009
Last updated
30 Sep 2020
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Beraprost Sodium Modified Release in people with Pulmonary Arterial Hypertension, run by Lung Biotechnology PBC at 17 sites in 6 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 17 sites in United States, Germany, Romania, Belgium, Czechia and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 30 Sep 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline in Pulmonary Vascular Resistance at Week 12 (time frame: Week 12). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Sep 2020.

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