Pulmonary Artery Remodelling With Bosentan
Study Details
Study Description
Brief Summary
The main purpose of this study is to investigate whether bosentan (Tracleer®) affects the wall thickness of the pulmonary arteries in patients with idiopathic pulmonary arterial hypertension (iPAH) and PAH related to systemic sclerosis (PAH-SSc).
The second purpose is to investigate if bosentan affects the enlargement of small vessels in the lungs in response to natural chemicals in patients with iPAH and PAH-SSc.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 4 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: bosentan
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Drug: bosentan
Bosentan 62.5 mg bid for 4 weeks, then 125 mg bid
Other Names:
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Outcome Measures
Primary Outcome Measures
- Change from baseline (BL) to 6 mths in the IVUS-derived measurement of pulmonary artery wall thickness. [Baseline to 6 months]
- Change from BL to 6 mths in pulmonary microvascular circulation dilator responses to actylcholine (Ach). [Baseline to 6 months]
Secondary Outcome Measures
- Change from BL to 6 mths in each of the IVUS derived pulmonary artery parameters. [Baseline to 6 months]
- Change from BL to 6 mths in pulmonary microvascular circulation dilator responses to sodium nitroprusside. [Baseline to 6 months]
- Correlation between the change from BL to 6 mths of each of the IVUS-derived parameters and the pulmonary microvascular circulation (PMVC) dilator responses versus changes in PVR. [Baseline to 6 months]
- Correlation between the change from BL to 6 mths of each of the IVUS-derived parameters and the PMVC dilator responses versus changes in 6MWD. [Baseline to 6 months]
Eligibility Criteria
Criteria
Inclusion Criteria : · Men or women >18 years of age.·
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Symptomatic (modified NYHA class III) iPAH or PAH-SSc·
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PAH confirmed by right heart catheterization performed within 3 months before enrolment mPAP > 25 mmHg, PCWP < 15 mmHg and PVR > 3 mmHg/l/min.
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Women of childbearing potential must have a negative pre-treatment pregnancy test and use a reliable method of contraception during study treatment and for 3 months after study treatment termination.
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Bosentan naïve patients
Exclusion Criteria : · PAH other than iPAH or PAH-SSc
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Significant vasoreactivity during right heart catheterization defined as a fall in mPAP to < 40 mmHg with a decrease >= 10 mmHg and with a normal cardiac index (>= 2.5 l/min.m2)· Severe obstructive lung disease: FEV1/FVC < 0.5
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Severe restrictive lung disease: TLC < 0.7 of normal predicted value
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Hemoglobin <75% of the lower limit of the normal range· Systolic blood pressure < 85 mmHg
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Body weight < 40 kg
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Pregnancy or breast-feeding
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Moderate to severe hepatic impairment, i.e., Child-Pugh Class B or C.
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Baseline aminotransferases, i.e., aspartate aminotransferases (AST) and/or alanine aminotransferases (ALT) > 3 times the upper limit of the normal (ULN) range.
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Treatment for iPAH or PAH-SSc within 1 month before start of study treatment, excluding warfarin and acute administration of vasodilators for vascular reactivity testing during heart catheterization.
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Treatment with epoprostenol or other prostacyclin analogs for iPAH or PAH-SSc within 1 month before start of study treatment
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Treatment with glibenclamide (glyburide), fluconazole ketoconazole or ritonavir within 1 week before start of study treatment.
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Current treatment with cyclosporine A or tacrolimus
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Hypersensitivity to bosentan or any of the excipients of its formulation.
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Patient who received an investigational drug (such as sildenafil) within 3 months before start of study treatment
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Conditions that prevent compliance with the protocol or adherence to therapy.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Royal Prince Alfred Hospital | Camperdown | Australia |
Sponsors and Collaborators
- Actelion
Investigators
- Principal Investigator: David Celermajer, Professor, Royal Prince Alfred Hospital, Camperdown
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- AC-052-416