The Efficacy and Safety of Sildenafil Citrate Used in Combination With Intravenous Epoprostenol in PAH

Recruitment Details

Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
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Pre-Assignment Details

Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
Subjects were entered into the open-label extension study portion upon completion of the preceding 16-week, placebo controlled core study portion or, for subjects who required a change in epoprostenol dose due to clinical deterioration, after at least 4 weeks in the core study portion.

Reporting Groups

	Description
Placebo: Core Study / Sildenafil: Extension Study	Core Study: Placebo (16 weeks, or at least 4 weeks for subjects who required a change in epoprostenol dose due to clinical deterioration); Extension Study: Sildenafil (until last enrolled subject completed 3 years of treatment) - initial dose 20 mg TID (3 times daily), may have been increased to 40 mg TID or 80 mg TID at discretion of Investigator
Sildenafil: Core Study / Sildenafil: Extension Study	Core Study (16 weeks, or at least 4 weeks for subjects who required a change in epoprostenol dose due to clinical deterioration): Sildenafil 20, 40, or 80 mg TID (3 times daily) based on toleration; Extension Study (until last enrolled subject completed 3 years of treatment): Sildenafil - initial dose 20 mg TID, may have been increased to 40 mg TID or 80 mg TID at discretion of Investigator

Participant Flow for 2 periods

Period 1:   Core Study - 16 Weeks

	Placebo: Core Study / Sildenafil: Extension Study	Sildenafil: Core Study / Sildenafil: Extension Study
STARTED	133	134
Treated	131	134
COMPLETED	108 [1]	122 [2]
NOT COMPLETED	25	12
Death	3	0
Adverse Event	12	6
Lack of Efficacy	2	3
Reason Unspecified	5	3
Subject Defaulted	1	0
Randomized but not Treated	2	0

Period 2:   Extension Study - up to 3 Years

	Placebo: Core Study / Sildenafil: Extension Study	Sildenafil: Core Study / Sildenafil: Extension Study
STARTED	115 [1]	127 [1]
Treated	115	127
COMPLETED	53	56
NOT COMPLETED	62	71
Death	24	28
Adverse Event	14	14
Lack of Efficacy	5	1
Reason Unspecified	12	19
Withdrawal by Subject	7	9

Population Description

Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
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Reporting Groups

	Description
Placebo/Sildenafil	Core Study: Placebo; Extension Study: Sildenafil - initial dose 20 mg TID (3 times daily), may have been increased to 40 mg TID or 80 mg TID at discretion of Investigator
Sildenafil/Sildenafil	Study A1481141: Sildenafil 20, 40, or 80 mg TID (3 times daily) based on toleration; Extension Study A1481153: Sildenafil - initial dose 20 mg TID, may have been increased to 40 mg TID or 80 mg TID at discretion of Investigator
Total	Total of all reporting groups

Baseline Measures

	Placebo/Sildenafil	Sildenafil/Sildenafil	Total
Overall Participants Analyzed  [Units: Participants]	131	134	265
Age, Customized  [Units: Participants]
18 to 44 years	47	54	101
45 to 64 years	73	64	137
>= 65 years	11	16	27
Gender  [Units: Participants]
Female	102	110	212
Male	29	24	53

1.  Primary:

Categorized Change From Baseline in 6-Minute Walking Distance   [ Time Frame: 1 Year, 2 Year, 3 Year ]

2.  Secondary:

Survival Status   [ Time Frame: 1, 2, 3, 4, and 5 years ]

3.  Secondary:

Change in Pulmonary Hypertension Criteria for Functional Capacity and Therapeutic Class   [ Time Frame: 1 Year, 2 Year, 3 Year ]

4.  Secondary:

Change From Baseline in Medical Outcomes Study Short Form 36 (SF-36)   [ Time Frame: Baseline, Month 15, Month 27, Month 39 ]

5.  Secondary:

Change From Baseline in European Quality of Life Scale (EuroQol) 5-Dimensions (EQ-5D): Utility Index Score   [ Time Frame: Baseline, Month 15, Month 27, Month 39 ]

6.  Secondary:

Change From Baseline in European Quality of Life (EuroQol) Visual Analogue Scale (EQ-5D VAS): Current Health State Score   [ Time Frame: Baseline, Month 15, Month 27, Month 39 ]

7.  Secondary:

Change From Baseline in Medical Outcomes Study Short Form 36 (SF-36): Reported Health Transition Score   [ Time Frame: Baseline, Month 15, Month 27, Month 39 ]

8.  Secondary:

Change From Baseline in BORG Dyspnea Score   [ Time Frame: Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Month 9, Month 12, Month 15, Month 18, Month 21, Month 24, Month 27, Month 30, Month 33, Month 36 ]

9.  Other Pre-specified:

Change in Epoprostenol Dose From Baseline Maintained for 6 Months   [ Time Frame: Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Month 9, and at 3-month intervals through Month 69 ]

Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
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