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Ambrisentan in Patients With Porto-pulmonary Hypertension A Multicenter Open Label Trial (Portopulm)

This study is currently recruiting participants. (see Contacts and Locations)
Verified July 2014 by Tufts Medical Center
Sponsor:
Collaborator:
Gilead Sciences
Information provided by (Responsible Party):
Tufts Medical Center
ClinicalTrials.gov Identifier:
NCT01224210
First received: October 18, 2010
Last updated: July 22, 2014
Last verified: July 2014

October 18, 2010
July 22, 2014
March 2010
September 2014   (final data collection date for primary outcome measure)
Change in PVR [ Time Frame: from baseline to Week 24 ] [ Designated as safety issue: No ]
Change in PVR from baseline to Week 24 for all patients (using cardiac output [CO] measured by the thermodilution method and reported as percent difference from baseline).
Same as current
Complete list of historical versions of study NCT01224210 on ClinicalTrials.gov Archive Site
6 Minute Walk Distance [ Time Frame: Change from baseline to Week 24 ] [ Designated as safety issue: No ]
Change from baseline in 6MWD at Week 24 for all patients. (difference measured in meters).
Same as current
Not Provided
Not Provided
 
Ambrisentan in Patients With Porto-pulmonary Hypertension A Multicenter Open Label Trial
Ambrisentan in Patients With Porto-pulmonary Hypertension A Multicenter Open Label Trial

This is an Open Label, Multicenter, pilot clinical trial to assess the efficacy and safety of an oral selective Endothelin Receptor Antagonist (ambrisentan) in patients with portopulmonary hypertension.

Preliminary evidence suggests that ambrisentan is safe and effective in patients with portopulmonary hypertension. The goal of therapy for these patients is to improve symptoms of dyspnea and to improve pulmonary hemodynamics to a mean pulmonary artery pressure <35 mm Hg in order to make patients eligible for liver transplantation. Therefore, the primary endpoints for this study will include 6 minute walk distance (6MWD) and pulmonary vascular resistance (PVR).

Eligible subjects will receive 5 mg ambrisentan once-daily for the first 4 weeks. After the initial 4-week period, investigators will increase study drug dose to 10 mg once daily (both 5 mg and 10 mg doses are FDA approved). If 10 mg is not tolerated in the opinion of investigator, then the investigator may decrease the dose back to 5 mg once daily. Primary outcome is a change in both the 6MWD and in PVR from baseline to Week 24. Subjects will be monitored with liver function tests (LFT) every 2 weeks for the first 8 weeks, then every 4 weeks thereafter. These safety laboratory tests may be performed at a local phlebotomy laboratory or at the Investigator clinic. In addition, the Investigator will assess each subject for safety and efficacy at Week 4, Week 12, and Week 24. Following Week 24, subjects will be assessed for safety and efficacy every 12 weeks. Patients will be followed for a total of 1 year. After 1 year, if the Investigator feels that continuing the treatment will be beneficial to the patients, they will be provided with ambrisentan by Gilead Pharmaceuticals, free of charge.

Not Provided
Interventional
Not Provided
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Portopulmonary Hypertension
Drug: Ambrisentan
Ambrisentan once-daily in the morning with or without food. The adult dose selected for this study will be 5 mg for the first 4 weeks. After the initial 4 weeks the dose will be increased to 10mg (available doses are 5, and 10 mg) based on tolerance safety. Subjects will remain on 10mg until they complete the study. Dose adjustments may be made based on side effects.
Other Name: Letairis
Ambrisentan
Open Label Ambrisentan
Intervention: Drug: Ambrisentan
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
30
March 2015
September 2014   (final data collection date for primary outcome measure)

Inclusion Criteria:

Subjects need to fulfill all of the following 4 criteria:

  1. Evidence of portal hypertension (by hemodynamic measurement, or by Doppler flow of portal circulation, or by clinical evidence of portal hypertension such as esophageal or gastric varices, as evidenced by prior upper endoscopy).
  2. Evidence of pulmonary arterial hypertension by right heart catheterization (all three criteria need to be present) Right heart catheterization may have been performed up to 30 days prior to screening

    • Mean PAP (pulmonary artery pressure) >25 mm Hg, and
    • PVR (pulmonary vascular resistance) >240 dynes/s/cm5, and
    • TPG (transpulmonary gradient = meanPAP -PAWP) >12 mm Hg
  3. Baseline AST, ALT < 5 times the upper limit of normal, total Bili < 3.0 mg/dl, and mild liver impairment with Child -Pugh class A or B
  4. Ages 18 years and above

Exclusion Criteria:

  1. Presence of any other etiology of pulmonary arterial hypertension (HIV, connective tissue disease, sickle cell, left heart failure, chronic thromboembolic PH, etc)
  2. Treatment with prostacyclins, other ERAs, or PDE5 inhibitors within 30 days of enrollment.
  3. Moribund state or anticipated death within 1 month.
  4. AST or ALT ≥ 5 times upper limit of normal
  5. Total bilirubin ≥ 3.0 mg/dl
  6. Significant lung disease (obstructive lung disease with FEV1 < 1L, or FEV1/FVC <50%; or restrictive lung disease with Total Lung Capacity < 60% predicted). PFTs may have been performed up to 6 months prior to enrollment.
  7. Pregnancy
  8. Age <18 years
  9. Child -Pugh class C
Both
18 Years and older
No
Contact: Karen Visnaw, RN, BS, ADN 617-636-1334 Kvisnaw@Tuftsmedicalcenter.org
United States
 
NCT01224210
Ambrisentan Portopulm Study
Yes
Tufts Medical Center
Tufts Medical Center
Gilead Sciences
Principal Investigator: Ioana Preston, MD Tufts Medical Center
Tufts Medical Center
July 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP