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Haemodynamic Effects of Apelin Agonists and Antagonists in Man in COPD With Raised Pulmonary Artery Pressures

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT02129309
First Posted: May 2, 2014
Last Update Posted: June 25, 2015
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Collaborators:
Wellcome Trust
University of Cambridge
Information provided by (Responsible Party):
Joseph Cheriyan, MD, Cambridge University Hospitals NHS Foundation Trust
  Purpose

The investigators are interested in studying how Pulmonary Hypertension occurs. A substance called 'apelin', that naturally occurs in the body has been shown to have an important role in heart disease. Previous studies have shown that it can make blood vessels get wider, and help blood flow around the body and thus improve the way the heart and lungs work.

The investigators are looking to recruit both healthy and COPD pulmonary hypertension patients to study 3 types of apelin. The purpose of this study is to help the investigators understand how Pulmonary Hypertension occurs which may will help with the development of future treatments.


Condition Intervention
COPD Pulmonary Hypertension Procedure: Forearm plethysmography Procedure: Haemodynamic studies

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Prevention
Official Title: Haemodynamic Effects of Apelin Agonists and Antagonists in Man in COPD With Raised Pulmonary Artery Pressures.

Further study details as provided by Joseph Cheriyan, MD, Cambridge University Hospitals NHS Foundation Trust:

Primary Outcome Measures:
  • Percentage change in forearm blood flow in the infused arm. Forearm blood flow ratio in each arm, blood pressure and heart rate will also be reported. [ Time Frame: 12 months ]
  • Cardiac output and stroke volume, pulmonary vascular resistance, mean arterial pressure and heart rate. [ Time Frame: 12 months ]

Other Outcome Measures:
  • Exploratory endpoints in Study 2 are systolic and diastolic blood pressure. [ Time Frame: 12 months ]

Enrollment: 20
Study Start Date: June 2014
Study Completion Date: December 2014
Primary Completion Date: December 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Systemic Apelin infusion

Study 2a - Haemodynamic studies to investigate the response to systemic infusions of 3 apelin agonists in healthy volunteers

Study 2b - Haemodynamic studies to investigate the response to 3 apelin agonists in COPD patients with elevated pulmonary artery pressures

Procedure: Haemodynamic studies
Dose response study
Other Names:
  • Innocor
  • Bioimpedance
  • Echocardiography
Experimental: Apelin infusion - forearm

Study 1a - A validation dose study of 3 apelin agonists using forearm plethysmography to evaluate changes in forearm blood flow: performed in healthy volunteers and COPD patients with elevated pulmonary artery pressures.

Study 1b- A validation dose study of apelin receptor antagonist using forearm plethysmography to evaluate changes in forearm blood flow, in healthy volunteers and COPD patients with elevated pulmonary artery pressures.

Procedure: Forearm plethysmography
Dose response study

Detailed Description:

The purpose of this study:

To investigate the physiological role of apelin in the cardiovascular system in patients with COPD with raised pulmonary artery pressures.

Study Aim and hypotheses:

The primary objective is to test the above hypotheses using forearm blood flow and systemic infusions of apelin peptides.

Hypotheses:

  1. Apelin agonists are vasodilators in human resistance vessels and this effect will be altered in patients with pulmonary hypertension.
  2. Apelin peptides improve right ventricular and pulmonary haemodynamics in patients with elevated pulmonary artery pressures.

Study 1a - A validation dose study of 3 apelin agonists performed in healthy volunteers and COPD patients with elevated pulmonary artery pressures.

Study 1b- A validation dose study of apelin receptor antagonist, in healthy volunteers and COPD patients with elevated pulmonary artery pressures.

Study 2a - To define the haemodynamic response to apelin agonists in healthy volunteers and evaluate the response.

Study 2b - To investigate the haemodynamic response to 3 apelin agonists in COPD patients with elevated pulmonary artery pressures.

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Healthy volunteers

    • Aged 18 to 70 years
    • Non-smoker (<1 cigarette per week)
    • If female, postmenopausal or on days 2-9 of menstrual cycle and negative pregnancy test COPD patients with estimated Pulmonary Artery Pressure (PAP) on echo >25mmHg
    • Clinical diagnosis of COPD as per standard criteria
    • Between 18 and 70 years
    • If female, postmenopausal or on days 2-9 of menstrual cycle and negative pregnancy test

Exclusion Criteria:

  • pre-existing:

    • Systemic Hypertension (sustained BP >160/100mmHg)
    • Ischaemic Heart Disease
    • Primary valvular heart disease
    • Significant left ventricular failure
    • Active malignancy
    • Renal disease (Creatinine >180 µmol/L)
    • Neurological disease
    • Diabetes mellitus
    • BMI >35, BMI <17
    • Pregnancy
    • Use of vasoactive medication or NSAIDS/aspirin within 48 hours of study.
    • Current involvement in other research studies, other than observational/non-interventional
    • Known HIV
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02129309


Locations
United Kingdom
Vascular Research Unit, Clinical Pharmacology Unit, ACCI, Level 3, Addenbrooke's Hospital, Hills Road
Cambridge, United Kingdom, CB2 0QQ
Sponsors and Collaborators
Cambridge University Hospitals NHS Foundation Trust
Wellcome Trust
University of Cambridge
Investigators
Principal Investigator: Dr. Joseph Cheriyan, MD Cambridge University Hospitals NHS Foundation Trust
  More Information

Responsible Party: Joseph Cheriyan, MD, Consultant Physician & Clinical Pharmacologist, Cambridge University Hospitals NHS Foundation Trust
ClinicalTrials.gov Identifier: NCT02129309     History of Changes
Other Study ID Numbers: ALPHa-COPD
First Submitted: April 28, 2014
First Posted: May 2, 2014
Last Update Posted: June 25, 2015
Last Verified: January 2015

Keywords provided by Joseph Cheriyan, MD, Cambridge University Hospitals NHS Foundation Trust:
COPD
Apelin
agonist
antagonist

Additional relevant MeSH terms:
Hypertension, Pulmonary
Lung Diseases
Respiratory Tract Diseases