Safety and Efficacy of Fluoxetine in Pulmonary Arterial Hypertension

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Kelly M Chin, University of Texas Southwestern Medical Center
ClinicalTrials.gov Identifier:
NCT00942708
First received: July 19, 2009
Last updated: June 10, 2015
Last verified: June 2015
  Purpose

This study will evaluate the safety, tolerability and efficacy of open-label fluoxetine for three months among patients with pulmonary arterial hypertension.


Condition Intervention Phase
Pulmonary Arterial Hypertension
Drug: Fluoxetine
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Safety and Efficacy of Fluoxetine in Pulmonary Arterial Hypertension

Resource links provided by NLM:


Further study details as provided by University of Texas Southwestern Medical Center:

Primary Outcome Measures:
  • The primary endpoint will be change in pulmonary vascular resistance (PVR) measured by right heart catheterization after three months of therapy. [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Efficacy, Safety and tolerability endpoints will include change between baseline and three month QIDS-SR depression scale, systolic and diastolic blood pressure (systemic) and tabulation of adverse events [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]

Enrollment: 6
Study Start Date: September 2009
Study Completion Date: August 2011
Primary Completion Date: June 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Fluoxetine
Fluoxetine will be added starting at 20 mg and titrated as tolerated to 80 mg daily.
Drug: Fluoxetine

Total dose How to take:

Week 1-2 20 mg daily Week 3-4 40 mg daily Week 5-6 40 mg BID Week 7-12 40mg BID

Other Names:
  • Total dose How to take:
  • Week 1-2 20 mg daily
  • Week 3-4 40 mg daily
  • Week 5-6 40 mg BID
  • Week 7-12 40mg BID

Detailed Description:

Idiopathic pulmonary arterial hypertension (PAH) is a life-threatening disorder of uncertain cause that leads to progressive right heart failure and death. Average survival has improved from about 2.8 years in the early 1990s to approximately 5-7 years with current treatments, but most patients will still die of their disease. Two classes of oral medications are approved for use in PAH: endothelin-1 antagonists, and phosphodiesterase-5 inhibitors. Both improve walk distance and symptoms in PAH, but most patients still have continued dyspnea, fatigue and significant elevations in pulmonary pressures. Those who remain severely impaired are generally started on a continuous intravenous prostacyclin. For those who are less ill but still symptomatic, few options are available.

Primary endpoint: the primary endpoint will be change in pulmonary vascular resistance (PVR) measured by right heart catheterization after three months of therapy.

Secondary endpoints

Efficacy:

  • Other three month catheterization variables: right atrial pressure, pulmonary arterial pressure, Fick cardiac output, pulmonary arterial oxygen saturation, pulmonary capillary wedge pressure
  • Six minute walk distance
  • WHO functional class
  • Brain natriuretic peptide

Safety and tolerability endpoints will include change between baseline and three month QIDS-SR depression scale, systolic and diastolic blood pressure (systemic) and tabulation of adverse events to include but not limited to:

  • Death
  • Hospitalization
  • Symptomatic hypotension
  • Gastrointestinal side effects
  • Depression
  Eligibility

Ages Eligible for Study:   16 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Signed informed consent prior to any study-mandated procedure
  2. PAH of the following subtypes: idiopathic PAH WHO functional class II-III
  3. Catheterization within one week showing mPAP >=25, wedge or LV end diastolic pressure ≤15, and PVR > 4 wood units, and baseline fick cardiac output results available
  4. Age 16-75
  5. Able to complete a six minute walk distance
  6. Women of childbearing potential*: negative serum pre-treatment pregnancy test + consistently and correctly uses a reliable method of contraception** Oral approved PAH therapy for >3 months with no change in dose for > 1 month

Exclusion Criteria:

  1. PAH with connective tissue disease, congenital heart disease, portal hypertension, glycogen storage disease, Gaucher's disease, hereditary hemorrhagic telangiectasia, hemoglobinopathy, myeloproliferative disorders.
  2. Moderate to severe obstructive or restrictive lung disease: forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) < 70% and FEV1 < 60% of predicted value after bronchodilator administration. -or- total lung capacity (TLC) < 60% of predicted.
  3. Systemic systolic blood pressure <100 mmHg Breastfeeding
  4. Significant liver, renal or other medical disease preventing completion of the study procedures or with life expectancy <12 months, or any other acute or chronic physical impairment (other than dyspnea), limiting the ability to comply with study requirements
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00942708

Locations
United States, Texas
UT Southwestern Medical Center
Dallas, Texas, United States, 75390
Sponsors and Collaborators
University of Texas Southwestern Medical Center
Investigators
Principal Investigator: Kelly M Chin, MD UT Southwestern Medical Center
  More Information

No publications provided

Responsible Party: Kelly M Chin, Assistant Professor, University of Texas Southwestern Medical Center
ClinicalTrials.gov Identifier: NCT00942708     History of Changes
Other Study ID Numbers: CTSA NIH Grant UL1-RR024982
Study First Received: July 19, 2009
Last Updated: June 10, 2015
Health Authority: United States: Institutional Review Board

Keywords provided by University of Texas Southwestern Medical Center:
Pulmonary Arterial Hypertension
Pulmonary Hypertension

Additional relevant MeSH terms:
Hypertension
Cardiovascular Diseases
Vascular Diseases
Fluoxetine
Antidepressive Agents
Antidepressive Agents, Second-Generation
Central Nervous System Agents
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Agents
Neurotransmitter Uptake Inhibitors
Pharmacologic Actions
Physiological Effects of Drugs
Psychotropic Drugs
Serotonin Agents
Serotonin Uptake Inhibitors
Therapeutic Uses

ClinicalTrials.gov processed this record on August 02, 2015