Pulmonary Arterial HypertensionPhase 4ARTISANNCT05203510
A Study of a Mean Pulmonary Artery Pressure-Targeted Approach With Early and Rapid Treprostinil Therapy to Reverse Right Ventricular Remodeling in Participants With Pulmonary Arterial Hypertension
A Phase 4 study testing Parenteral Treprostinil and Oral Treprostinil in people with Pulmonary Arterial Hypertension, run by United Therapeutics at 28 sites in United States.
Trial summary
The primary objective of this study is to assess the effect of early and rapid treprostinil therapy for mean pulmonary artery pressure (mPAP) reduction to improve right ventricular (RV) function and reverse RV remodeling in participants with pulmonary arterial hypertension (PAH). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Pulmonary Arterial Hypertension
- What is being tested?
- Parenteral Treprostinil and Oral Treprostinil
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 52 participants
- Where
- 28 sitesUnited States
- Study dates
- 20 Oct 2022to 30 Apr 2028
- Phase
- Phase 4
- Are there results?
- Not yet: the study is under way
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
- Confirmed PAH (WHO Group 1) classified by one of the following subgroups:
- Idiopathic, heritable or drug/toxin induced (with the exception of amphetamine-induced PAH)
- Associated with repaired congenital systemic-to-pulmonary shunts (repaired ≥1 year)
- Associated with connective tissue disease
- Associated with human immunodeficiency virus infection
- Baseline visit right heart catheterization (RHC) must also meet the following criteria:
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- mPAP >35 mmHg
- Pulmonary vascular resistance (PVR) >2 Wood units
- Pulmonary artery wedge pressure (PAWP) ≤15 mmHg
- On a stable dose of an endothelin receptor antagonist (ERA) and/or phosphodiesterase type 5 inhibitor (PDE-5i) or soluble guanylate cyclase stimulator (sGC) therapy or if treatment naïve, willing to take one of these medications in addition to study drug
- REVEAL Lite 2 risk score ≤9
- WHO FC II or III
- 6MWD >165 meters
Who cannot join
- PAH-related Exclusion Criteria:
- Prior or current use of epoprostenol, treprostinil, iloprost, beraprost, or selexipag
- Positive vasoreactivity test in idiopathic, heritable, or drug/toxin induced PAH
- Amphetamine use within the past 12 months
- WHO Groups 2, 3, 4, and 5
- Use of any other investigational drug, device, or therapy within 30 days of the Baseline visit
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- Moderate or severe hepatic impairment (Child-Pugh Class B and C)
- Any other clinically significant illness or abnormal laboratory value(s) measured during screening that, in the opinion of the Investigator, might adversely affect interpretation of the study data or participant safety (for example, active infection, chronic thromboembolic pulmonary hypertension, or acute/recent deep vein thrombosis or pulmonary embolism)
- Chronic atrial fibrillation, multiple premature ventricular or atrial contractions of clinical significance, or any other condition that would interfere with proper cardiac gating during cMRI
- Permanent cardiac pacemaker or automatic internal cardioverter that would interfere with conduct of cMRI
- Metallic implant (for example, defibrillator, neurostimulator, hearing aid, permanent infusion device, implantable pump, or body plates/screws/bolts) that would interfere with conduct of cMRI
- CardioMEMS-related Exclusion Criteria, if applicable:
- Previously implanted with CardioMEMS pulmonary artery Sensor or unwilling/unable to permit collection and perform upload (transmission) of pulmonary artery pressure (PAP) readings
- Unable to take dual antiplatelet or anticoagulation therapy for 30 days after CardioMEMS PA Sensor implantation unless the participant has an indication for warfarin or direct oral anticoagulant
- NOTE: Other inclusion and exclusion criteria may apply.
Trial locations and contacts
28 sites in 1 country.
28 sites in 1 country
United States28 sites
Georgia Clinical Research
Austell, Georgia, 30106
Brigham and Women's Hospital
Boston, Massachusetts, 02115
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, 27599
Medical University of South Carolina
Charleston, South Carolina, 29425
Northwestern Memorial Hospital
Chicago, Illinois, 60611
University of Cincinnati
Cincinnati, Ohio, 45267
The Ohio State University Wexner Medical Center
Columbus, Ohio, 43210
UT Southwestern Medical Center
Dallas, Texas, 75390
Henry Ford Health System
Detroit, Michigan, 48202
Duke University Medical Center
Durham, North Carolina, 27710
University of California San Francisco - Fresno
Fresno, California, 93701
Prisma Health
Greenville, South Carolina, 29605
Hartford Hospital
Hartford, Connecticut, 06106
Indiana University Health North Hospital
Indianapolis, Indiana, 46202
Community Health Network
Indianapolis, Indiana, 46219
Cedars-Sinai Medical Center
Los Angeles, California, 90048
Morristown Medical Center
Morristown, New Jersey, 07960
Integris Baptist Medical Center
Oklahoma City, Oklahoma, 73112
University of Nebraska Medical Center
Omaha, Nebraska, 68198
Temple Hospital
Philadelphia, Pennsylvania, 19140
Banner University Medical Center (University of Arizona)
Phoenix, Arizona, 85006
HonorHealth John C. Lincoln Medical Center
Phoenix, Arizona, 85020
Carilion Clinic
Roanoke, Virginia, 24014
University of Rochester Medical Center
Rochester, New York, 14623
University of California Davis Medical Center
Sacramento, California, 95817
University of California San Francisco Pulmonary, Critical Care, Allergy and Sleep Medicine
San Francisco, California, 94143
USF
Tampa, Florida, 33606
Oklahoma Heart Institute
Tulsa, Oklahoma, 74104
About this study
Official title: A Phase 4, Prospective, Multicenter, Single-Arm Study of a Mean Pulmonary Artery Pressure-Targeted Approach With Early and Rapid Treprostinil Therapy to Reverse Right Ventricular Remodeling in Patients With Pulmonary Arterial Hypertension: ARTISAN (Afterload Reduction To Improve Right Ventricular Structure And FuNction)
The primary objective of this study is to assess the effect of early and rapid treprostinil therapy for mean pulmonary artery pressure (mPAP) reduction to improve right ventricular (RV) function and reverse RV remodeling in participants with pulmonary arterial hypertension (PAH).
- Conditions
- Pulmonary Arterial Hypertension
- Being tested
- Parenteral Treprostinil, Oral Treprostinil
- 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.
Parenteral TreprostinilDrug
Also called Remodulin
Parenteral treprostinil will be administered per schedule specified in the arm description.
Oral TreprostinilDrug
Also called Orenitram
Oral treprostinil will be administered per schedule specified in the arm description.
| Study group | Role | What they receive |
|---|---|---|
| Treprostinil | Experimental | Participants will receive parenteral treprostinil at initial dose of 1.25 nanograms/kilogram/minute (at minimum) either intravenously or subcutaneously. Based on mPAP assessments and after a minimum dose of parenteral treprostinil is reached, at Investigator's (PI's) discretion, participants may transition to oral treprostinil and continue dose uptitration for further reduction of mPAP. Based on Month 12 mPAP assessment, participants may transition from parenteral to oral treprostinil at PI's discretion after completion of Month 12 assessment and continue uptitration for further reduction of mPAP. If minimum dose of parenteral treprostinil is not reached at Month 6/12 at PI's discretion, uptitration of parenteral treprostinil or oral treprostinil transition may occur to maintain normal mPAP.
Treprostinil therapy (parenteral or oral) may continue as tolerated toward goal of further reduction of mPAP until Month 36. Receives: Drug: Parenteral Treprostinil; Drug: Oral Treprostinil |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline in Right Ventricular Ejection Fraction (RVEF), as Measured by Cardiac Magnetic Resonance Imaging (cMRI) at Month 12
Measured: Baseline, Month 12
Secondary outcomes (13)
Change From Baseline in mPAP at Month 12
Measured: Baseline, Month 12
Number of Participants With Clinical Improvement From Baseline to Month 12, 24, and 36
Clinical improvement is defined as meeting all 3 criteria: - improvement in six-minute walk distance (6MWD) increase ≥10% or ≥30 meters; - improvement in World Health Organization (WHO) functional class (FC) or maintenance of WHO FC I/II; - improvement in N-terminal pro-brain natriuretic peptide (NT-proBNP) decrease ≥30% or <300 ng/liter (L).
Measured: Baseline to Months 12, 24, and 36
Change From Baseline in RV-Pulmonary Artery (PA) Coupling Estimated by the Ratio of Stroke Volume by End Systolic Volume at Month 12
Measured: Baseline, Month 12
Change From Baseline in RV End-Diastolic Volume Index at Month 12
Measured: Baseline, Month 12
Change From Baseline in RV Stroke Volume Index at Month 12
Measured: Baseline, Month 12
Change From Baseline in 6MWD at Month 12, 24, and 36
Measured: Baseline, Months 12, 24, and 36
Change From Baseline in Registry to EValuate EArly and Long-Term PAH Disease Management (REVEAL) Lite 2 Risk Score at Months 12, 24, and 36
Measured: Baseline, Months 12, 24, and 36
Change From Baseline in WHO FC at Months 12, 24, and 36
Measured: Baseline, Months 12, 24, and 36
Change From Baseline in NT-proBNP at Months 12, 24, and 36
Measured: Baseline, Months 12, 24, and 36
Change From Baseline in Borg Dyspnea Score at Months 12, 24, and 36
Measured: Baseline, Months 12, 24, and 36
Change From Baseline in RV-PA Coupling Estimated by the Ratio of Tricuspid Annular Plane Systolic Excursion by Pulmonary Artery Systolic Pressure (TAPSE/PASP) at Months 12, 24, and 36
Measured: Baseline, Months 12, 24, and 36
Survival Rate: Number of Participants who Survived at Months 12, 24, and 36
Measured: Baseline to Months 12, 24, and 36
Change From Baseline in mPAP at Months 24 and 36
Measured: Baseline, Months 24 and 36
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jan 2022
- Study start20 Oct 2022
- Primary completion30 Apr 2026 (estimated)
- Study completion30 Apr 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Pulmonary Arterial HypertensionStudies 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 4
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 52 participants (actual)
Sponsor and investigators
- Lead sponsor
- United Therapeutics
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Lung Biotechnology PBC
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05203510
- Sponsor's protocol ID
- REM-PH-418
- Acronym
- ARTISAN
- Status last verified
- May 2025
- First submitted
- 10 Jan 2022
- Last updated
- 9 Dec 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 9 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 4, Prospective, Multicenter, Single-Arm Study of a Mean Pulmonary Artery Pressure-Targeted Approach With Early and Rapid Treprostinil Therapy to Reverse Right Ventricular Remodeling in Patients With Pulmonary Arterial Hypertension: ARTISAN (Afterload Reduction To Improve Right Ventricular Structure And FuNction)
- ClinicalTrials.gov ID
- NCT05203510
- Acronym / sponsor ID
- ARTISAN / REM-PH-418
- Conditions
- Pulmonary Arterial Hypertension
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 52 participants (actual)
- Lead sponsor
- United TherapeuticsIndustry (pharma, biotech, devices)
- Collaborators
- Lung Biotechnology PBC
- Study start
- 20 Oct 2022 (actual)
- Primary completion
- 30 Apr 2026 (estimated)
- Study completion
- 30 Apr 2028 (estimated)
- First posted
- 24 Jan 2022 (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.
The primary objective of this study is to assess the effect of early and rapid treprostinil therapy for mean pulmonary artery pressure (mPAP) reduction to improve right ventricular (RV) function and reverse RV remodeling in participants with pulmonary arterial hypertension (PAH).
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Treprostinil | Experimental | Drug: Parenteral Treprostinil, Drug: Oral TreprostinilParticipants will receive parenteral treprostinil at initial dose of 1.25 nanograms/kilogram/minute (at minimum) either intravenously or subcutaneously. Based on mPAP assessments and after a minimum dose of parenteral treprostinil is reached, at Investigator's (PI's) discretion, participants may transition to oral treprostinil and continue dose uptitration for further reduction of mPAP. Based on Month 12 mPAP assessment, participants may transition from parenteral to oral treprostinil at PI's discretion after completion of Month 12 assessment and continue uptitration for further reduction of mPAP. If minimum dose of parenteral treprostinil is not reached at Month 6/12 at PI's discretion, uptitration of parenteral treprostinil or oral treprostinil transition may occur to maintain normal mPAP. Treprostinil therapy (parenteral or oral) may continue as tolerated toward goal of further reduction of mPAP until Month 36. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (13 listed)
- Confirmed PAH (WHO Group 1) classified by one of the following subgroups:
- Baseline visit right heart catheterization (RHC) must also meet the following criteria:
- On a stable dose of an endothelin receptor antagonist (ERA) and/or phosphodiesterase type 5 inhibitor (PDE-5i) or soluble guanylate cyclase stimulator (sGC) therapy or if treatment naïve, willing to take one of these medications in addition to study drug
- REVEAL Lite 2 risk score ≤9
- WHO FC II or III
Key exclusion criteria (15 listed)
- Prior or current use of epoprostenol, treprostinil, iloprost, beraprost, or selexipag
- Positive vasoreactivity test in idiopathic, heritable, or drug/toxin induced PAH
- Amphetamine use within the past 12 months
- WHO Groups 2, 3, 4, and 5
- Use of any other investigational drug, device, or therapy within 30 days of the Baseline visit
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 |
|---|---|---|
| Parenteral TreprostinilAlso: RemodulinParenteral treprostinil will be administered per schedule specified in the arm description. | Drug | Treprostinil |
| Oral TreprostinilAlso: OrenitramOral treprostinil will be administered per schedule specified in the arm description. | Drug | Treprostinil |
Primary outcome
Change From Baseline in Right Ventricular Ejection Fraction (RVEF), as Measured by Cardiac Magnetic Resonance Imaging (cMRI) at Month 12
Time frame: Baseline, Month 12
13 secondary outcomes
Change From Baseline in mPAP at Month 12
Time frame: Baseline, Month 12
Number of Participants With Clinical Improvement From Baseline to Month 12, 24, and 36
Time frame: Baseline to Months 12, 24, and 36
Change From Baseline in RV-Pulmonary Artery (PA) Coupling Estimated by the Ratio of Stroke Volume by End Systolic Volume at Month 12
Time frame: Baseline, Month 12
Change From Baseline in RV End-Diastolic Volume Index at Month 12
Time frame: Baseline, Month 12
Change From Baseline in RV Stroke Volume Index at Month 12
Time frame: Baseline, Month 12
Change From Baseline in 6MWD at Month 12, 24, and 36
Time frame: Baseline, Months 12, 24, and 36
Change From Baseline in Registry to EValuate EArly and Long-Term PAH Disease Management (REVEAL) Lite 2 Risk Score at Months 12, 24, and 36
Time frame: Baseline, Months 12, 24, and 36
Change From Baseline in WHO FC at Months 12, 24, and 36
Time frame: Baseline, Months 12, 24, and 36
Change From Baseline in NT-proBNP at Months 12, 24, and 36
Time frame: Baseline, Months 12, 24, and 36
Change From Baseline in Borg Dyspnea Score at Months 12, 24, and 36
Time frame: Baseline, Months 12, 24, and 36
Change From Baseline in RV-PA Coupling Estimated by the Ratio of Tricuspid Annular Plane Systolic Excursion by Pulmonary Artery Systolic Pressure (TAPSE/PASP) at Months 12, 24, and 36
Time frame: Baseline, Months 12, 24, and 36
Survival Rate: Number of Participants who Survived at Months 12, 24, and 36
Time frame: Baseline to Months 12, 24, and 36
Change From Baseline in mPAP at Months 24 and 36
Time frame: Baseline, Months 24 and 36
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Dec 2025.
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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.
28 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Parenteral Treprostinil and Oral Treprostinil in people with Pulmonary Arterial Hypertension, run by United Therapeutics at 28 sites in United States.
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 13 inclusion and 15 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: under way, not looking for participants, as of the sponsor's last update on 9 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 28 sites in United States. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
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 Right Ventricular Ejection Fraction (RVEF), as Measured by Cardiac Magnetic Resonance Imaging (cMRI) at Month 12 (time frame: Baseline, Month 12). 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 9 Dec 2025.