PAHPhase 3NCT03626688
A Study Evaluating the Efficacy and Safety of Ralinepag to Improve Treatment Outcomes in PAH Patients
A Phase 3 study testing Ralinepag in people with PAH and Pulmonary Hypertension, run by United Therapeutics at 209 sites in 33 countries.
Trial summary
Study ROR-PH-301, ADVANCE OUTCOMES, is designed to assess the efficacy and safety of ralinepag when added to pulmonary arterial hypertension (PAH) standard of care or PAH-specific background therapy in subjects with World Health Organization (WHO) Group 1 PAH. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- PAH, Pulmonary Hypertension, Pulmonary Arterial Hypertension
- What is being tested?
- Ralinepag
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 687 participants
- Where
- 209 sitesin 33 countries
- Study dates
- 24 Jan 2019to 31 Dec 2025
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- At least 18 years of age.
- Evidence of a personally signed and dated informed consent form indicating that the subject has been informed of all pertinent aspects of the study prior to initiation of any study-related procedures.
- Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures
- Primary diagnosis of symptomatic PAH.
- Has had a right heart catheterization (RHC) performed at or within 3 years prior to Screening (RHC will be performed during Screening if not available) that is consistent with the diagnosis of PAH.
- Has WHO/ NYHA functional class II to IV symptoms.
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- If on PAH-specific background oral therapy, subject is on stable therapy with either an endothelin receptor antagonist (ERA) and/or a phosphodiesterase type 5 inhibitor (PDE5-I) or a soluble guanylate cyclase (sGC) stimulator.
- Has a 6MWD of ≥150 meters.
- If taking concomitant medications that may affect the clinical manifestations of PAH (eg, calcium channel blockers, diuretics, digoxin, or L arginine supplementation, beta blockers, angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers), must be on a stable dose for at least 30 days prior to the Baseline Visit and the dosage maintained throughout the study. The exception is that the dose of diuretics must be stable for at least the 10 days prior to Baseline.
- Both male and female subjects agree to use a highly effective method of birth control throughout the entire study period from informed consent through to the 30-Day Follow-up Visit, if the possibility of conception exists. Eligible male and female subjects must also agree not to participate in a conception process during the study and for 30 days after the last dose of IMP. Eligible male subjects must agree not to participate in sperm donation for 90 days after the last dose of IMP.
Who cannot join
- For subjects with known HIV-associated PAH, a cluster designation 4 (CD4+) T-cell count <200/mm3 within 90 days of Baseline.
- Must not have 3 or more left ventricular dysfunction risk factors as defined in the study protocol.
- Has evidence of more than mild lung disease on pulmonary function tests performed within 180 days prior to, or during Screening.
- Has evidence of thromboembolic disease as determined by a V/Q lung scan or local standard of care diagnostic evaluation at or after diagnosis of PAH.
- Current diagnosis of ongoing and clinically significant sleep apnea as defined by the Investigator.
- Male subjects with a corrected QT interval using Fridericia's formula (QTcF) >450 msec and female subjects with a QTcF >470 msec on ECG recorded at Screening and analyzed by the central ECG laboratory. Subjects with evidence of intraventricular conduction delay, defined as a QRS interval greater than 110 msec, will be excluded if the QTcF is >500 msec for both males and females.
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- Severe chronic liver disease (ie, Child-Pugh Class C), portal hypertension, cirrhosis or complications of cirrhosis/portal hypertension (eg, history of variceal hemorrhage, encephalopathy).
- Confirmed active infection with hepatitis B virus (HBV) or hepatitis C virus (HCV).
- Subjects with alanine aminotransferase or aspartate aminotransferase ≥3 times the upper limit of normal (ULN) or total bilirubin ≥2 × ULN at Screening.
- Chronic renal insufficiency as defined by serum creatinine >2.5 mg/dL or requiring dialysis at Screening.
- Hemoglobin concentration <9 g/dL at Screening.
- Subjects treated with an IV or SC prostacyclin pathway agent (eg, epoprostenol, treprostinil, or iloprost) or activin signaling inhibitor for PAH at any time prior to Baseline (use in vasoreactive testing is permitted).
- Subjects currently on or who were treated with an inhaled or oral prostacyclin pathway agent (iloprost, treprostinil, beraprost, or selexipag) for >6 months or within 90 days prior to Baseline.
- Subject has pulmonary veno-occlusive disease.
- Malignancy diagnosed and/or treated within 5 years prior to Screening, with the exception of localized non-metastatic basal cell or squamous cell carcinoma of the skin or in-situ carcinoma of the cervix excised with curative intent.
- Subject tests positive for amphetamine, cocaine, methamphetamine, methylenedioxymethamphetamine or phencyclidine in urine drug screen performed at Screening, or has a recent history (6 months) of alcohol or drug abuse. A subject will not be excluded due to a positive drug screen caused by prescribed medications.
- Initiation or discontinuation of a cardio-pulmonary rehabilitation program based upon exercise within 90 days prior to Screening and/or planned during study participation.
- Prior participation in any study of ralinepag or participation in another interventional clinical study with medicinal products within 30 days prior to Screening. Concurrent participation in registry or observational studies is allowed, as long as the subject can fulfill all other entry criteria and comply with all study procedures.
- Any reason that, in the opinion of the Investigator or Medical Monitor, precludes the subject from participating in the study (eg, any previous or intercurrent medical condition) that may increase the risk associated with study participation or that would confound study analysis or impair study participation or cooperation.
- Known hypersensitivity to ralinepag or any of the excipients.
- Life expectancy <12 months based on the Investigator's opinion.
- Women who are pregnant, lactating or breast-feeding.
Trial locations and contacts
209 sites in 33 countries.
209 sites in 33 countries
United States68 sites
University of New Mexico
Albuquerque, New Mexico, 87131
Emory University Hospital
Atlanta, Georgia, 30322
University of Colorado Hospital
Aurora, Colorado, 80045
Piedmont Healthcare Pulmonary and Critical Care Research
Austell, Georgia, 30106
Ascension Texas Cardiovascular
Austin, Texas, 78705
University of Maryland Medical Center
Baltimore, Maryland, 21201
University of Alabama at Birmingham
Birmingham, Alabama, 35294
Tufts Medical Center
Boston, Massachusetts, 02111
Massachusetts General Hospital
Boston, Massachusetts, 02114
Boston University Medical Center
Boston, Massachusetts, 02118
University of Virginia Medical Center
Charlottesville, Virginia, 22908
University of Chicago Medical Center
Chicago, Illinois, 60637
University of Cincinnati-Medical Science Building
Cincinnati, Ohio, 45267
Cleveland Clinic
Cleveland, Ohio, 44195
Vermont Lung Center
Colchester, Vermont, 05446
The Ohio State University Wexner Medical Center
Columbus, Ohio, 43210
Baylor University Medical Center
Dallas, Texas, 75246
UT Southwestern Medical Center
Dallas, Texas, 75390
National Jewish Health
Denver, Colorado, 80206
Duke University Medical Center
Durham, North Carolina, 27710
Ascension Alexian Brothers
Elk Grove Village, Illinois, 60007
University of Florida
Gainesville, Florida, 32610
Spectrum Health Medical Group
Grand Rapids, Michigan, 49546
East Carolina University
Greenville, North Carolina, 27834
Memorial Hermann Hospital
Houston, Texas, 77030
The Methodist Hospital Research Institute
Houston, Texas, 77030
Indiana University School of Medicine
Indianapolis, Indiana, 46202
Community Health Network Cancer Center North
Indianapolis, Indiana, 46250
St. Vincent Medical Group, Inc.
Indianapolis, Indiana, 46260
University of Iowa Hospitals and Clinics
Iowa City, Iowa, 52242
Statcare Pulmonary Consultants
Knoxville, Tennessee, 37919
UCSD Health Sciences
La Jolla, California, 92037
Loma Linda University Medical Center
Loma Linda, California, 92354
Ronald Reagan UCLA Medical Center
Los Angeles, California, 90024
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California, 90027
Keck Hospital of USC
Los Angeles, California, 90033
Cedars-Sinai Medical Center
Los Angeles, California, 90048
VA Greater Los Angeles Healthcare System
Los Angeles, California, 90073
Kentuckiana Pulmonary Research Center
Louisville, Kentucky, 40202
University of Miami
Miami, Florida, 33136
Medical College of Wisconsin/Froedtert Hospital
Milwaukee, Wisconsin, 53226
Winthrop Hospital
Mineola, New York, 11501
Ochsner Medical Center
New Orleans, Louisiana, 70121
NYU Langone Medical Center
New York, New York, 10016
Weill-Cornell-New York Presbyterian Hospital
New York, New York, 10021
Mount Sinai School of Medicine
New York, New York, 10029
Sentara Cardiovascular Research Institute
Norfolk, Virginia, 23507
Integris Baptist Medical Center
Oklahoma City, Oklahoma, 73112
Nebraska Medical Center
Omaha, Nebraska, 68198
University of California, Irvine
Orange, California, 19103
Central Florida Pulmonary Group
Orlando, Florida, 32803
University of Pennsylvania
Philadelphia, Pennsylvania, 19104
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
Temple University
Philadelphia, Pennsylvania, 19140
St. Joseph's Hospital and Medical Center
Phoenix, Arizona, 85013
Allegheny General Hospital
Pittsburgh, Pennsylvania, 15212
Oregon Clinic-Pulmonary West
Portland, Oregon, 97225
Oregon Health & Science University
Portland, Oregon, 97239
Carilion Clinic Pulmonary and Sleep Medicine
Roanoke, Virginia, 24014
University of Rochester
Rochester, New York, 14642
University of California Davis Medical Center
Sacramento, California, 95817
SBPA Research LLC
Santa Barbara, California, 93105
Chest Medicine Associates
South Portland, Maine, 04106
Washington University School of Medicine
St Louis, Missouri, 63110
Stanford Healthcare
Stanford, California, 94305
LA Biomedical Research Institute Harbor-UCLA Medical Center
Torrance, California, 90502
University of Arizona
Tucson, Arizona, 85724
Cleveland Clinic Florida
Weston, Florida, 33331
Argentina12 sites
Sanatorio de la Trinidad Mitre
Buenos Aires, Buenos Aires, C1039AAO
Cardiologia Palmero
Caba, Buenos Aires F.D., 1425
Hospital Italiano
Ciudad Autonoma Buenos Aires, Buenos Aires, C1181ACH
Hospital Britanico de Buenos Aires
Ciudad Autonoma Buenos Aires, Ciudad Autonoma Buenos Aires, 1280
Fundacion Respirar
Ciudad Autonoma Buenos Aires, Ciudad Autonoma Buenos Aires, 1426
Fundacion Favaloro
Ciudad Autonoma Buenos Aires, Ciudad Autonoma Buenos Aires, C1093AAS
Hospital Privado Centro Medico de Cordoba S.A
Córdoba, Córdoba Province, X5016KEH
Hospital Italiano de Cordoba
Córdoba, X5004BAL
Instituto de Cardiologia de Corrientes
Corrientes, Corrientes Province
Instituto de Investigaciones Clinicas Mar del Plata
Mar del Plata, Buenos Aires, 7600
Sanatorio Parque
Rosario, Santa Fe Province, 2000
Hospital PROVINCIAL "Dr. Jose Maria Cullen"
Santa Fe, Santa Fe Province, 3000
Australia11 sites
Royal Prince Alfred Hospital
Camperdown, New South Wales, 2050
The Prince Charles Hospital
Chermside, Queensland, 4032
St Vincent's Hospital Sydney
Darlinghurst, New South Wales, 2010
St Vincent's Hospital Melbourne
Fitzroy, Victoria, 3065
Royal Hobart Hospital
Hobart, Tasmania, 7000
Nepean Hospital
Kingswood, New South Wales, 2751
Macquarie University
Macquarie, New South Wales, 2109
The Alfred Hospital
Melbourne, Victoria, 3004
Fiona Stanley Hospital
Murdoch, Western Australia, 6150
Westmead Hospital
Sydney, New South Wales, 2145
Princess Alexandra Hospital
Woolloongabba, Queensland, 4102
France11 sites
CHU Besançon - Hôpital Jean Minjoz
Besançon, 25030
CHU de Brest - Hôpital de la Cavale Blanche
Brest, 29609
CHU Lyon - Hôpital Cardio-Vasculaire et Pneumologique Louis Pradel, Service de Pneumologie, 59 Boulevard Pinel
Bron, Rhone, 69677
CHU de Grenoble - Hôpital Albert Michallon, Clinique de Cardiologie, Boulevrad de la Chantourne
Grenoble, Isere, 38048
Groupement Hospitalier Sud - Hôpital Bicêtre
Le Kremlin-Bicêtre, Val de Marne, 94275
CHRU de Lille - Hopital Cardiologique
Lille, 59037
Hôpital Nord - CHU Marseille
Marseille, 13015
CHU de Rouen - Hôpital Charles Nicolle
Rouen, Seine Maritime, 76031
CHU de Saint-Etienne - Hopital Nord, Service de Medecine vasculaire et therapeutique, 81 Avenue A. Raimond
Saint-Étienne-de-Montluc, Pays de la Loire Region, 42005
CHU de Strasbourg - Nouvel Hôpital Civil, Ctre de competence Hypertension Arterielle Pulmona, 1 place de l Hopital
Strasbourg, Bas Rhin, 67091
CHU Nancy - Hôpital de Brabois Adultes, Pneumologie- Oncologie Médicale, Rue du Morvan
Vandœuvre-lès-Nancy, Meurthe et Moselle, 54511
Germany8 sites
Schwarzwald-Baar Klinikum
Donaueschingen, 78166
Universitaetsklinikum Carl Gustav Carus TU Dresden
Dresden, 01307
Universitätsmedizin Greifswald
Greifswald, Mecklenburg-Vorpommern, 17475
Universitaetsklinikum Hamburg-Eppendorf
Hamburg, 20246
Thoraxklinik-Heidelberg Zentrum für Pulmonale Hypertonie
Heidelberg, Baden-Wurttemberg, 69126
Universitaetsklinikum des Saarlandes, Innere Medizin V, IMED, Kirrberger Strasse 100, Gebäude 41
Homburg, Saarland, 66424
Universitätsklinikum Leipzig, Medizinische Klinik II, Pneumologie
Leipzig, Saxony, 04103
Universitaetsmedizin der Johannes-Gutenberg-Universitaet Mainz, Zentrum für Kardiologie I, Centrum für Thrombose und Hämostase (CTH), Langenbeckstrasse 1
Mainz, Rhineland-Palatinate, 55131
Brazil7 sites
Instituto das Pequenas Missionárias de Maria Imaculada - Hospital Madre Teresa
Belo Horizonte, Minas Gerais, 30441-070
UNESP-Faculdade de Medicina da Universidade Estadual Paulista Campus Botucatu
Botucatu, São Paulo, 18618-687
HC-UFG - Hospital das Clínicas da Universidade Federal de Goiás
Goiânia, Goiás, 74605-020
Hospital Sao Lucas da PUC-RS
Porto Alegre, R.S, 90610-000
Irmandade da Santa Casa de Misericórdia de Porto Alegre
Porto Alegre, Rio Grande do Sul, 90035-074
Hospital Sao Paulo
São Paulo, São Paulo, 04037-002
Instituto do Coracao
São Paulo, São Paulo, 05403-000
Italy7 sites
Azienda Ospedaliero Universitaria Ospedali Riuniti di Foggia, S.C. di Cardiologia, Viale Luigi Pinto, 1
Foggia, Foggia, 71100
IRCC Ospedale Policlinico San Martino
Genova, Genova, 16132
Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35
Milan, 20122
Azienda Socio Sanitaria Territoriale di Monza (Presidio San Gerardo)
Monza, 20900
Istituto Mediterraneo Trapianti e Terapie a Alta Specializzazione (IRCCS-ISMETT)
Palermo, PA, 90127
Fondazione IRCCS Policlinico San Matteo
Pavia, 27100
Azienda Ospedaliera Universitaria Policlinico Umberto I - Università di Roma La Sapienza, Viale del Policlinico, 155
Roma, Roma, 00161
Turkey (Türkiye)7 sites
Balcalı, Çukurova Üniversitesi Kardiyoloji ABD
Adana, Saricam, 01330
Gazi University Medical Faculty Hospital
Ankara, 06560
Uludag Universitesi Tip Fakültesi, Gorukle Kampusu
Bursa, 16059
Osmangazi Uni Medical Faculty
Eskişehir, Odunpazari, 26040
Marmara Universitesi Istanbul Pendik Egitim ve Arastirma Hastanesi
Istanbul, 34899
Dokuz Eylul Universitesi Tip Fakultesi, Mithatpasa caddesi Inciralti Balcova
Izmir, 35340
Mersin Üniversitesi Tip Fakültesi Ciftlikköy Kampüsü
Mersin, Yenisehir, 33343
Canada5 sites
Peter Lougheed Centre
Calgary, Alberta, T1Y 6J4
LHSC - Victoria Hospital
London, Ontario, N6A 5W9
SMBD Jewish General Hospital d/b/a Jewish General Hospital
Montreal, Quebec, H3T1E2
Institut Universitaire de Cardiologie et de Pneumologie de Quebec
Québec, Quebec, G1V 4G5
University Health Network-Toronto General Hospital
Toronto, Ontario, M5G 2N2
China5 sites
Beijing Shijitan Hospital, Capital Medical University
Beijing, Beijing Municipality, 100038
Fuwai Hospital, Chinese Academy of Medical Sciences
Beijing, 100037
Xiangya Hospital Central South University
Changsha, Hunan, 410008
Guangdong Provincial People's Hospital
Guangzhou, Guangdong, 510080
Shanghai Pulmonary Hospital
Shanghai, Shanghai Municipality, 200443
Israel5 sites
The Lady Davis Carmel Medical Center, 7 Michal st.
Haifa, 3436212
Hadassah Ein Kerem Medical Center, Kiryat Hadassah
Jerusalem, 9112001
Meir Medical Center, 59 Tshernichovski st.
Kfar Saba, 4428164
Rabin Medical Center-Beilinson Campus, Pulmonary Institute, 39 Jabotinsky St Ground floor
Petah Tikva, 4941492
Tel Aviv Sourasky Medical Center, 6 Weizmann St.
Tel Aviv, 6423906
Poland5 sites
Uniwersytecki Szpital Kliniczny w Bialymstoku, Klinika Kardiologii z Oddzialem Intensywnego Nazdoru Kardiologicznego, M. Sklodowskiej 24a
Bialystok, 15-276
Krakowski Szpital Specjalistyczny im. Jana Pawla II, Oddział Kliniczny Chorób Serca i Naczyń z Pododdziałem Intensywnego Nadzoru Kardiologicznego, Pradnicka 80
Krakow, 31-202
NZOZ Europejskie Centrum Zdrowia, ul. Borowa 14/18
Otwock, 05-400
Szpital Kliniczny Przemienienia Panskiego Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu, Oddzial Kardiologii - F, ul. Dluga 1/2
Poznan, 61-848
Premium Clinic Wrocław CM, Podwale 83/17
Wroclaw, 50-414
United Kingdom5 sites
Golden Jubilee National Hospital
Glasgow, West Dunbartonshire, G81 4DY
Royal Free London NHS Foundation Trust, Pond Street
London, Greater London, NW3 2QG
Royal Brompton Hospital
London, SW3 6NP
Imperial College Healthcare NHS Trust
London, W12 0HS
The Newcastle upon Tyne Hospitals NHS Foundation Trust, Sir William Leech Lung Research Centre
Newcastle upon Tyne, Tyne and Wear, NE7 7DN
Greece4 sites
University General Hospital of Alexandroupolis
Alexandroupoli, 68100
"Onasseio" Cardiosurgery Hospital, Hemodynamic Research and Interventional Cardiology Dept., 356, Syggrou Avenue
Athens, Kallithea, 17674
University General Hospital Attikon
Chaïdári, 12462
AHEPA General Hospital of Thessaloniki, A' Cardiology Clinic, 1 St. Kyriakidi Street
Thessaloniki, 54636
Mexico4 sites
CICUM San Miguel
Guadalajara, Jalisco, 44160
Instituto Nacional de Cardiologia Dr Ignacio Chavez Rivera
Mexico City, Mexico City, 14080
Instituto Nacional de Ciencias Médicas y Nutricion Dr. Salvador Zubiran
Mexico City, Mexico City, 14080
Unidad de Investigacion Clinica en Medicina, S.C.
Monterrey, N.L., 64718
Portugal4 sites
Hospital Garcia de Orta, E.P.E
Almada, 2805-267
Centro Hospitalar e Universitário de Coimbra, E.P.E.
Coimbra, 3000-075
Centro Hospitalar Universitário Lisboa Norte, E.P.E. Hospital Pulido Valente
Lisbon, 1769-001
Centro Hospitalar de Santo António E.P.E.
Porto, Porto District, 4099-001
Romania4 sites
Institutul de Urgenta pentru Boli Cardiovasculare "Prof. Dr. C.C. Iliescu", Sos. Fundeni nr. 258
Bucharest, 022328
Institutul de Pneumoftiziologie "Marius Nasta", Sos. Viilor nr. 90, Sector 5
Bucharest, 050159
Institutul Inimii "Niculae Stancioiu" Cluj-Napoca, Cardiologie, Str. Motilor nr. 19-21
Cluj-Napoca, 400001
Spitalul Clinic de Boli Infectioase si Pneumoftiziologie "Dr. Victor Babes" Timisoara, Str. Gheorghe Adam nr. 13
Timișoara, 300310
Spain4 sites
Hospital Universitari Vall d'Hebron, Respiratory Dept., Passeig Vall d'Hebron,119-129, Neumologia
Barcelona, 08035
Hospital Clinic de Barcelona, C/ Villarroel, 170
Barcelona, 08036
Hospital Universitario 12 de Octubre
Madrid, Madrid, 28041
Hospoital Universitari i Politecnic La Fe
Valencia, Valencia, 46026
Austria3 sites
Medizinische Universität Innsbruck
Innsbruck, 6020
Ordensklinikum Linz GmbH - Elisabethinen, Fadingerstrasse 1
Linz, 4020
AKH Wien, Innere Med. II, Kardiologie, Währingergürtel 18-20
Vienna, 1090
Hungary3 sites
Gottsegen György Országos Kardiovaszkuláris Intézet
Budapest, Budapest, 1096
Pecsi Tudomanyegyetem, Szivgyogyaszati Klinika, Ifjusag u. 13.
Pécs, 7624
Szegedi Tudományegyetem Szent-Györgyi Albert Klinikai Központ Családorvosi Intézet és Rendelő
Szeged, Csongrád-Csanád, Hungary
Serbia3 sites
Clinical Center of Serbia, Koste Todorovica 8
Belgrade, 11000
Clinical Center Zemun. Clinic for internal medicine, Department of Cardiology
Belgrade, 11080
Institute for Pulmonary Diseases of Vojvodina, Put Dr Goldmana 4
Kamenitz, 21204
South Korea3 sites
Gachon University Hospital Gil Medical Center
Incheon, Namdong-gu, 21565
Samsung Medical Center
Seoul, Gangnam-gu, 06351
Seoul National University Hospital
Seoul, Jongno-gu, 03080
Sweden3 sites
Sahlgrenska Universitetssjukhuset
Gothenburg, 41345
Linköping Universitetssjukhuset
Linköping, 58185
Norrlands Universitetssjukhus, Hjärtcentrum
Umeå, 90185
Ukraine3 sites
CE Dniprop RCC&C Center of Dniprop RC Dept of Card SI DMA of MOHU, Chair of Internal Medicine 3, 28, Knyazya Volodymyra Velykogo St.
Dnipro, 49070
SI F.H.Yanovskyi National Institute of Phthisiology and Pulmonology of NAMSU, Clinical and Functional Dept, 10, Amosova St.
Kyiv, 03680
Communal Noncommercial Enterprise of Lviv Regional Council Lviv Clinical Hospital, Dept of Cardiology, D.Halytskyi Lviv NMU, Ch of Internal Medicine #1, 7, Chernihivska str.
Lviv, 79010
Belgium2 sites
Cliniques Universitaires de Bruxelles Hopital Erasme
Brussels, 1070
UZ Leuven, UZ Leuven Campus Gasthuisberg, Herestraat 49
Leuven, 3000
Bulgaria2 sites
MHAT "Sveta Anna" Sofia AD
Sofia, Sofia, 1750
MHAT - "National Heart Hospital" EAD, 65, Konyovitza Str.
Sofia, 1309
Croatia2 sites
Clinical Hospital Dubrava Zagreb, Avenija G.Šuška 6
Zagreb, 10000
University Clinic for Pulmonary Diseases, Jordanovac 104
Zagreb, 10000
Denmark2 sites
Århus Universitetshospital
Aarhus, 8200
Copenhagen University Hospital (Rigshospitalet)
Copenhagen, 2100
Singapore2 sites
National University Hospital
Singapore, Singapore, 119074
National Heart Centre
Singapore, 169609
Taiwan2 sites
National Cheng Kung University Hospital
Tainan, 704
National Taiwan University Hospital
Taipei, Taipei, 10002
Czechia1 site
Vseobecna fakultni nemocnice v Praze, II. interni klinika kardiologie a angiologie VFN a 1. LF UK, U nemocnice 2
Prague, 128 08
Netherlands1 site
VU Medisch Centrum, De Boelelaan 1117
Amsterdam, 1081 HV
About this study
Official title: A Phase 3, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of Ralinepag When Added to PAH Standard of Care or PAH Specific Background Therapy in Subjects With WHO Group 1 PAH
Study ROR-PH-301, ADVANCE OUTCOMES, is designed to assess the efficacy and safety of ralinepag when added to pulmonary arterial hypertension (PAH) standard of care or PAH-specific background therapy in subjects with World Health Organization (WHO) Group 1 PAH.
Read the detailed description
Study ROR-PH-301 is a multicenter, randomized, double-blind, placebo-controlled study. Subjects who meet entry criteria will be randomly allocated 1:1 to receive ralinepag or placebo, in addition to their standard of care or PAH-specific background therapy, as applicable. The primary endpoint is the time (in days) from randomization to the first adjudicated protocol-defined clinical worsening event. All primary endpoint events will be adjudicated by an independent Clinical Event Committee (CEC) in a blinded fashion. Subjects who have a confirmed primary endpoint event adjudicated by the CEC at any time during the study and all subjects on treatment at the conclusion of the study who have completed the Week 28 Visit (after the target number of confirmed events is achieved) will have the option to enroll in an open-label extension (OLE) study. Subjects who do not choose to participate in the OLE study will discontinue study drug and should remain in the study for long-term follow-up of survival status and will receive standard of care PAH treatment, at the discretion of the treating physician.
- Conditions
- PAH, Pulmonary Hypertension, Pulmonary Arterial Hypertension, Hypertension, Connective Tissue Diseases, Familial Primary Pulmonary Hypertension
- Being tested
- Ralinepag, Placebo
- Keywords
- Prostacyclin, Connective Tissue Disease-Associated, 6 Minute Walk Test, 6 Minute Walk Distance, Pulmonary Vascular Resistance, Right Ventricular Function
- Medical subject headings
- Hypertension, Pulmonary, Pulmonary Arterial Hypertension, Hypertension, Connective Tissue Diseases, Familial Primary Pulmonary Hypertension, Vascular Diseases, Cardiovascular Diseases, Lung Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RalinepagDrug
Also called APD811
Active
PlaceboDrug
Placebo
| Study group | Role | What they receive |
|---|---|---|
| Ralinepag | Experimental | Ralinepag once daily extended-release tablets (oral) 50, 250, and 400 mcg titrated to the highest tolerated dose. Receives: Drug: Ralinepag |
| Placebo | Placebo comparator | Matching placebo tablets (oral) Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time from randomization to the first adjudicated protocol-defined clinical worsening event
Clinical worsening events are defined as death, nonelective hospital admission for worsening PAH (further defined in clinical study protocol), initiation of parenteral or inhaled prostacyclin pathway agent for treatment of worsening PAH, disease progression (further defined in clinical study protocol), or unsatisfactory long-term clinical response (further defined in clinical study protocol).
Measured: The study duration was event-based. This parameter was assessed from randomization until the conclusion of the study, up to 3 years
Secondary outcomes (11)
Change from Baseline in N-terminal pro-brain natriuretic peptide (NT-proBNP)
NT-proBNP was measured at Baseline (prior to starting study drug) and Week 4, 8, 12, and 16, then every 12 weeks thereafter including the End of Study/Early Termination Visit.
Measured: Baseline to Week 28
Change from Baseline in 6-minute walk distance (6MWD)
6MWD was measured at Baseline (prior to starting study drug) and Week 4, 8, 12, and 16, then every 12 weeks thereafter including the End of Study/Early Termination Visit.
Measured: Baseline to Week 28
Change from Baseline in WHO/New York Heart Association (NYHA) Functional Class
The severity of PAH was graded according to the functional status of the subject and assessed at every visit.
Measured: Baseline to Week 28
Shift and proportion of subjects who attain all 3 of the following: NT-proBNP level <300 pg/mL, 6MWD >440 meters, and WHO/NYHA Functional Class I or II
Data from NT-proBNP, 6MWD, and WHO/NYHA functional class assessment were compiled as a composite endpoint at visits through Week 28.
Measured: Baseline to Week 28
Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL) risk score
Data from NT-proBNP, 6MWD, WHO/NYHA functional class, systolic blood pressure, heart rate, and estimated glomerular filtration rate values collected at visits through Week 28 were used to calculate the composite REVEAL risk score.
Measured: Baseline to Week 28
Clinical improvement as defined by the absence of clinical worsening and fulfillment of at least 2 of the 3 of the following: increase in 6MWD ≥10% or ≥30 m, improvement to or maintenance of WHO FC I or II, and decrease in NT-proBNP by at least 30%.
Data from 6MWD, WHO/NYHA functional class assessment, and NT-proBNP were compiled as a composite endpoint at visits through Week 28.
Measured: Baseline to Week 28
Change from Baseline in health-related quality of life as measured by patient-reported outcomes.
Quality of life was assessed using patient-reported outcomes at Baseline (prior to starting study drug) and Week 16, then every 12 weeks thereafter including the End of Study/Early Termination Visit.
Measured: Baseline to Week 28
Time to first all-cause nonelective hospitalization
All nonelective hopsitalizations during the study period were collected.
Measured: The study duration was event-based. This parameter was assessed from randomization until the conclusion of the study (when the target number of adjudicated events was achieved, as defined in the study protocol).
Time to all-cause mortality
All deaths during the study period were collected.
Measured: The study duration was event-based. This parameter was assessed from randomization until the conclusion of the study (when the target number of adjudicated events was achieved, as defined in the study protocol).
Change from Baseline in heart rate recovery (HRR) following completion of the 6MWT
HRR was measured at Baseline (prior to starting study drug) and Week 4, 8, 12, and 16, then every 12 weeks thereafter including the End of Study/Early Termination Visit.
Measured: Baseline to Week 28
Safety and tolerability of ralinepag in subjects with PAH
Safety and tolerability were assessed by adverse events.
Measured: Baseline to Week 28
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Aug 2018
- Study start24 Jan 2019
- Primary completion31 Dec 2025
- Study completion31 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for PAHStudies of the same condition, open and under way.
- More trials run by United TherapeuticsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 687 participants (actual)
Sponsor and investigators
- Lead sponsor
- United Therapeutics
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03626688
- Sponsor's protocol ID
- ROR-PH-301
- Other IDs
- APD811-301
- Status last verified
- Jun 2026
- First submitted
- 27 Jul 2018
- Last updated
- 16 Jun 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
McLaughlin VV, Solum D, Lachant D, Ataya A, Barbera JA, Meyer GB, Chang SA, Channick R, Church C, Feenstra J, Gaine S, Giannakoulas G, Jerjes-Sanchez C, Khanna D, Kim NH, Oudiz R, Preston IR, Sood N, Torres F, Vachiery JL, Pulido T, Cella D, Deng C, Escudero M, Lacasse V, Peterson L, Benza R, Humbert M; ADVANCE OUTCOMES Investigators. Ralinepag for the treatment of pulmonary arterial hypertension (ADVANCE OUTCOMES): a randomised, double-blind, placebo-controlled phase 3 study. Lancet. 2026 Aug 8;408(10554):521-531. doi: 10.1016/S0140-6736(26)01011-1. Epub 2026 Jul 28.
PubMed 42520828
Study at a glance
From the registry record, last updated by the sponsor on 16 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of Ralinepag When Added to PAH Standard of Care or PAH Specific Background Therapy in Subjects With WHO Group 1 PAH
- ClinicalTrials.gov ID
- NCT03626688
- Acronym / sponsor ID
- ROR-PH-301
- Conditions
- PAH, Pulmonary Hypertension, Pulmonary Arterial Hypertension, Hypertension, Connective Tissue Diseases, Familial Primary Pulmonary Hypertension
- Keywords
- Prostacyclin, Connective Tissue Disease-Associated, 6 Minute Walk Test, 6 Minute Walk Distance, Pulmonary Vascular Resistance, Right Ventricular Function
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 687 participants (actual)
- Lead sponsor
- United TherapeuticsIndustry (pharma, biotech, devices)
- Study start
- 24 Jan 2019 (actual)
- Primary completion
- 31 Dec 2025 (actual)
- Study completion
- 31 Dec 2025 (actual)
- First posted
- 13 Aug 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Study ROR-PH-301, ADVANCE OUTCOMES, is designed to assess the efficacy and safety of ralinepag when added to pulmonary arterial hypertension (PAH) standard of care or PAH-specific background therapy in subjects with World Health Organization (WHO) Group 1 PAH.
Detailed description
Study ROR-PH-301 is a multicenter, randomized, double-blind, placebo-controlled study. Subjects who meet entry criteria will be randomly allocated 1:1 to receive ralinepag or placebo, in addition to their standard of care or PAH-specific background therapy, as applicable. The primary endpoint is the time (in days) from randomization to the first adjudicated protocol-defined clinical worsening event. All primary endpoint events will be adjudicated by an independent Clinical Event Committee (CEC) in a blinded fashion. Subjects who have a confirmed primary endpoint event adjudicated by the CEC at any time during the study and all subjects on treatment at the conclusion of the study who have completed the Week 28 Visit (after the target number of confirmed events is achieved) will have the option to enroll in an open-label extension (OLE) study. Subjects who do not choose to participate in the OLE study will discontinue study drug and should remain in the study for long-term follow-up of survival status and will receive standard of care PAH treatment, at the discretion of the treating physician.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Ralinepag | Experimental | Drug: RalinepagRalinepag once daily extended-release tablets (oral) 50, 250, and 400 mcg titrated to the highest tolerated dose. |
| Placebo | Placebo comparator | Drug: PlaceboMatching placebo tablets (oral) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- At least 18 years of age.
- Evidence of a personally signed and dated informed consent form indicating that the subject has been informed of all pertinent aspects of the study prior to initiation of any study-related procedures.
- Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures
- Primary diagnosis of symptomatic PAH.
- Has had a right heart catheterization (RHC) performed at or within 3 years prior to Screening (RHC will be performed during Screening if not available) that is consistent with the diagnosis of PAH.
Key exclusion criteria (22 listed)
- For subjects with known HIV-associated PAH, a cluster designation 4 (CD4+) T-cell count <200/mm3 within 90 days of Baseline.
- Must not have 3 or more left ventricular dysfunction risk factors as defined in the study protocol.
- Has evidence of more than mild lung disease on pulmonary function tests performed within 180 days prior to, or during Screening.
- Has evidence of thromboembolic disease as determined by a V/Q lung scan or local standard of care diagnostic evaluation at or after diagnosis of PAH.
- Current diagnosis of ongoing and clinically significant sleep apnea as defined by the Investigator.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| RalinepagAlso: APD811Active | Drug | Ralinepag |
| PlaceboPlacebo | Drug | Placebo |
Primary outcome
Time from randomization to the first adjudicated protocol-defined clinical worsening event
Time frame: The study duration was event-based. This parameter was assessed from randomization until the conclusion of the study, up to 3 years
Clinical worsening events are defined as death, nonelective hospital admission for worsening PAH (further defined in clinical study protocol), initiation of parenteral or inhaled prostacyclin pathway agent for treatment of worsening PAH, disease progression (further defined in clinical study protocol), or unsatisfactory long-term clinical response (further defined in clinical study protocol).
11 secondary outcomes
Change from Baseline in N-terminal pro-brain natriuretic peptide (NT-proBNP)
Time frame: Baseline to Week 28
Change from Baseline in 6-minute walk distance (6MWD)
Time frame: Baseline to Week 28
Change from Baseline in WHO/New York Heart Association (NYHA) Functional Class
Time frame: Baseline to Week 28
Shift and proportion of subjects who attain all 3 of the following: NT-proBNP level <300 pg/mL, 6MWD >440 meters, and WHO/NYHA Functional Class I or II
Time frame: Baseline to Week 28
Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL) risk score
Time frame: Baseline to Week 28
Clinical improvement as defined by the absence of clinical worsening and fulfillment of at least 2 of the 3 of the following: increase in 6MWD ≥10% or ≥30 m, improvement to or maintenance of WHO FC I or II, and decrease in NT-proBNP by at least 30%.
Time frame: Baseline to Week 28
Change from Baseline in health-related quality of life as measured by patient-reported outcomes.
Time frame: Baseline to Week 28
Time to first all-cause nonelective hospitalization
Time frame: The study duration was event-based. This parameter was assessed from randomization until the conclusion of the study (when the target number of adjudicated events was achieved, as defined in the study protocol).
Time to all-cause mortality
Time frame: The study duration was event-based. This parameter was assessed from randomization until the conclusion of the study (when the target number of adjudicated events was achieved, as defined in the study protocol).
Change from Baseline in heart rate recovery (HRR) following completion of the 6MWT
Time frame: Baseline to Week 28
Safety and tolerability of ralinepag in subjects with PAH
Time frame: Baseline to Week 28
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Jun 2026.
- Derived from this study: PubMed 42520828McLaughlin VV, Solum D, Lachant D, Ataya A, Barbera JA, Meyer GB, Chang SA, Channick R, Church C, Feenstra J, Gaine S, Giannakoulas G, Jerjes-Sanchez C, Khanna D, Kim NH, Oudiz R, Preston IR, Sood N, Torres F, Vachiery JL, Pulido T, Cella D, Deng C, Escudero M, Lacasse V, Peterson L, Benza R, Humbert M; ADVANCE OUTCOMES Investigators. Ralinepag for the treatment of pulmonary arterial hypertension (ADVANCE OUTCOMES): a randomised, double-blind, placebo-controlled phase 3 study. Lancet. 2026 Aug 8;408(10554):521-531. doi: 10.1016/S0140-6736(26)01011-1. Epub 2026 Jul 28.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
209 sites in 33 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Ralinepag in people with PAH and Pulmonary Hypertension, run by United Therapeutics at 209 sites in 33 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 10 inclusion and 22 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 16 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 209 sites in United States, Argentina, Australia, France, Germany and 28 more countries. 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. Some participants in this study may receive a placebo. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Time from randomization to the first adjudicated protocol-defined clinical worsening event (time frame: The study duration was event-based. This parameter was assessed from randomization until the conclusion of the study, up to 3 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03626688, which also lists 1 linked publication.
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 16 Jun 2026; AzTrials last refreshed its copy on 7 Nov 2026.