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Efficacy and Safety of Oral Bosentan in Patients With Idiopathic Pulmonary Fibrosis
This study has been completed.
First Received: October 23, 2003   Last Updated: July 22, 2008   History of Changes
Sponsor: Actelion
Information provided by: Actelion
ClinicalTrials.gov Identifier: NCT00071461
  Purpose

Endothelin-1 (ET-1) is expressed in a variety of pulmonary pathological conditions including pulmonary vascular disease and pulmonary fibrosis.

Bosentan (an oral dual ET-1 receptor antagonist) could delay the progression of idiopathic pulmonary fibrosis (IPF), a condition for which no established treatment is available.

The present trial investigates a possible use of bosentan, which is currently approved for the treatment of symptoms of pulmonary arterial hypertension (PAH) WHO class III and IV, to a new category of patients suffering from IPF.

The BUILD 1 showed, although not statistically significant, positive trends for pre-defined secondary endpoints, such as the combined incidence of death or treatment failure at 12 months.

It was therefore decided to offer Open Label treatment (bosentan) for patients willing to continue in the BUILD 1 study.


Condition Intervention Phase
Idiopathic Pulmonary Fibrosis
Drug: bosentan
Drug: Placebo
Phase II
Phase III

Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Parallel Assignment, Safety/Efficacy Study
Official Title: A Double-Blind, Randomized, Placebo-Controlled, Multicenter Study to Assess the Efficacy, Safety, and Tolerability of Bosentan in Patients With Idiopathic Pulmonary Fibrosis

Resource links provided by NLM:


Further study details as provided by Actelion:

Primary Outcome Measures:
  • Change in 6-minute walk distance [ Time Frame: Baseline to End-of-Period 1 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Death or treatment failure [ Time Frame: Up to End-of-Period 1 ] [ Designated as safety issue: No ]

Enrollment: 158
Study Start Date: August 2003
Study Completion Date: November 2005
Primary Completion Date: September 2005 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental

Initial dose: 62.5 mg b.i.d. for 4 weeks.

  • Target dose: - body weight > 40 kg (90 lb): 125 mg b.i.d., (if the initial dose is well tolerated).
  • body weight < 40 kg (90 lb): 62.5 mg b.i.d.
Drug: bosentan

Initial dose: 62.5 mg b.i.d. for 4 weeks.

  • Target dose: - body weight > 40 kg (90 lb): 125 mg b.i.d., (if the initial dose is well tolerated).
  • body weight < 40 kg (90 lb): 62.5 mg b.i.d.
2: Placebo Comparator

Initial dose: 62.5 mg b.i.d. for 4 weeks.

  • Target dose: - body weight > 40 kg (90 lb): 125 mg b.i.d., (if the initial dose is well tolerated).
  • body weight < 40 kg (90 lb): 62.5 mg b.i.d.
Drug: Placebo

Initial dose: 62.5 mg b.i.d. for 4 weeks.

  • Target dose: - body weight > 40 kg (90 lb): 125 mg b.i.d., (if the initial dose is well tolerated).
  • body weight < 40 kg (90 lb): 62.5 mg b.i.d.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

1.Male or female patients over 18 years of age.

  • Women must be either postmenopausal (i.e., amenorrhea for at least 1 year), or surgically or naturally sterile.
  • Women of childbearing potential must have a negative pre-treatment pregnancy test and use a reliable method of contraception during study treatment and for at least 3 months after study treatment termination.

    2.IPF proven diagnosis < 3 years documented according to ATS/ERS international multidisciplinary consensus, with or without surgical (thoracoscopic or open) chest lung biopsy 3.Duration of illness ≥ 3 months. 4.Six-minute walk test distance (limited by dyspnea) ≥ 150 meters and < 500 meters 5.Patients who have signed the informed consent form prior to initiation of any study procedure.

    1. Interstitial lung disease due to conditions other than IPF, including but not limited to radiation, sarcoidosis, hypersensitivity pneumonitis, bronchiolitis obliterans with organizing pneumonia, and cancer.
    2. History of clinically significant environmental exposure known to cause pulmonary fibrosis (drugs, asbestos, beryllium, radiation, domestic birds, etc.).
    3. Severe concomitant illness limiting life expectancy (< 1 year).
    4. FVC ≥ 90% predicted.
    5. Severe restrictive lung disease: FVC < 50% predicted or FVC < 1.2 l, or DLco < 30% predicted or residual volume ≥ 120% predicted.
    6. Severe obstructive lung disease: FEV1/FVC< 0.65.
    7. Documented improvement of patient's condition within 12 months prior to randomization with or without IPF-specific therapy (e.g., corticosteroids, immunosuppressive, cytotoxic or antifibrotic drugs, TNFa blocker, interferon g).
    8. Recent pulmonary or upper respiratory track infection (within 4 weeks of randomization).
    9. PaO2 < 55 mm Hg (sea level) or 50 mm Hg (altitude) at rest on room air.
    10. Echocardiographic evidence of severe pulmonary hypertension (PH): systolic pulmonary pressure ≥ 50 mm Hg or tricuspid regurgitation velocity ≥ 3.2 m/sec (unless severe PH is invalidated by a right heart catheterization). If the pulmonary pressure is not quantifiable, presence of significant right ventricular enlargement or hypertrophy or right ventricular dysfunction.
    11. Severe chronic heart failure, e.g., NYHA class III or IV and/or left ventricular ejection fraction < 25%.
    12. Acute or chronic impairment (other than dyspnea) limiting the ability to comply with study requirements, e.g., the 6MWT or the PFTs.

      (e.g., angina pectoris, intermittent claudicating, chronic arthritis).

    13. Baseline values of liver transaminases, i.e., aspartate aminotransferases (AST) and/or alanine aminotransferases (ALT) > 3 times the upper limit of normal ranges.
    14. Moderate to severe hepatic impairment, i.e., Child-Pugh Class B or C.
    15. Serum creatinine ≥ 2.5 mg/dl (221 mmol/l) or dialysis.
    16. Hemoglobin concentration < 75% the lower limit of normal ranges.
    17. Systolic blood pressure < 85 mm Hg.
    18. Pregnancy or breast-feeding.
    19. Current drug or alcohol dependence.
    20. Smoker (≥ 5 cigarettes per day) or former smoker (≥ 5 cigarettes per day) having stopped less than 6 months prior to randomization.
    21. Recently started (< 8 weeks from Screening visit) or planned cardio-pulmonary rehabilitation program based on exercise.
    22. Treatment with oral corticosteroids (> 15 mg/day prednisone or equivalent), immunosuppressive, cytotoxic or antifibrotic drugs such as TNF alpha blocker, or interferon gamma within 4 weeks of randomization.within 4 weeks of randomization.
    23. Treatment with glibenclamide (glyburide), cyclosporine A or tacrolimus within 1 weeks of randomization.
    24. Treatment with an endothelin receptor antagonist within 3 months of randomization.
    25. Treatment within 3 months of randomization or planned treatment with another investigational drug.
    26. Known hypersensitivity to bosentan or any of the excipients.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00071461

  Hide Study Locations
Locations
United States, Alabama
University of Alabama at Birmingham - Pulmonary Division
Birmingham, Alabama, United States, 35294
United States, California
University of California - Ambulatory Care Center
San Francisco, California, United States, 94143
David Geffen School of Medicine at UCLA - Division of Pulmonary and Critical Care Medicine
Los Angeles, California, United States, 90024
UCSD Medical Center
San Diego, California, United States, 92103
United States, Colorado
National Jewish Medical and Research Center
Denver, Colorado, United States, 80204
United States, Connecticut
Yale University School of Medicine
New Haven, Connecticut, United States, 06520
United States, Florida
Jackson Memorial Hospital
Miami, Florida, United States, 33136
United States, Iowa
University of Iowa Hospitals & Clinics - Department of Internal Medicine
Iowa city, Iowa, United States, 52242
United States, Michigan
University of Michigan Health System - Division of Pulmonary & Critical Care Medicine
Ann Arbor, Michigan, United States, 48109
United States, Minnesota
Mayo Medical School - Mayo Clinic
Rochester, Minnesota, United States, 55905
United States, Pennsylvania
University of Pittsburgh
Pittsburgh, Pennsylvania, United States, 15261
University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
United States, Tennessee
Vanderbilt University Medical Center
Nashville, Tennessee, United States, 37232
United States, Texas
Baylor College of Medicine
Houston, Texas, United States, 77030
United States, Washington
University of Washington - Division of Pulmonary & Critical Care Medicine
Seattle, Washington, United States, 98195
United States, Wisconsin
University of Wisconsin Hospitals & Clinics - Section of Pulmonary and Critical Care Medicine
Madison, Wisconsin, United States, 53792
Canada, British Columbia
University of British Columbia - St. Paul's Hospital
Vancouver, British Columbia, Canada, V6Z 1Y6
Canada, Ontario
Rosedale Medical Center
Toronto, Ontario, Canada, M4X 1W4
Canada, Quebec
Notre-Dame Hospital - Clinique du Thorax
Montreal, Quebec, Canada, H2L 4M1
France
Hôpital Avicenne - Université de Paris
Bobigny, France
Hôpital Louis Pradel
Lyon, France, 69000
Médecine Spécialisée Aigüe - CHU Grenoble
Grenoble, France, 38043
Germany
Medizinische Klinik und Poliklinik I Klinikum der Universität München
Munchen, Germany
Abt. Pneumologie Medizinische Klinik Universitätsklinikum Freiburg
Freiburg, Germany
Klinik Löwenstein gGmbH
Loewenstein, Germany
Israel
Sheba Medical Center
Tel-Hashomer, Israel
Italy
Section of Respiratory Diseases - Policlinico Le Scotte - Siena University
Siena, Italy
Switzerland
Inselspital
Bern, Switzerland
United Kingdom
Royal Brompton Hospital
London, United Kingdom
Sponsors and Collaborators
Actelion
  More Information

Additional Information:
No publications provided by Actelion

Additional publications automatically indexed to this study by National Clinical Trials Identifier (NCT ID):
Responsible Party: Actelion ( Sebastien Roux, MD )
Study ID Numbers: AC-052-320, BUILD 1
Study First Received: October 23, 2003
Last Updated: July 22, 2008
ClinicalTrials.gov Identifier: NCT00071461     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by Actelion:
Idiopathic pulmonary fibrosis
Interstitial lung disease
Bosentan
BUILD

Additional relevant MeSH terms:
Lung Diseases, Interstitial
Pathologic Processes
Respiratory Tract Diseases
Fibrosis
Therapeutic Uses
Lung Diseases
Cardiovascular Agents
Antihypertensive Agents
Pulmonary Fibrosis
Pharmacologic Actions
Bosentan

ClinicalTrials.gov processed this record on November 27, 2009