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BAY63-2521 - Long-term Extension Study in Patients With Chronic Thromboembolic Pulmonary Hypertension (CHEST-2)

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ClinicalTrials.gov Identifier: NCT00910429
Recruitment Status : Completed
First Posted : May 29, 2009
Results First Posted : October 22, 2020
Last Update Posted : October 22, 2020
Sponsor:
Information provided by (Responsible Party):
Bayer

Brief Summary:
Patients who have completed the 16 weeks treatment of the CHEST-1 trial (study number 11348) will be asked to participate in this long term extension study with BAY63-2521. The aim of the long term study is to collect additional information to evaluate the safety and tolerability of BAY63-2521. Patients will be treated with open label medication on their individual optimal dose between 0,5 mg - 2,5 mg tid.

Condition or disease Intervention/treatment Phase
Pulmonary Hypertension Drug: Riociguat (Adempas, BAY63-2521) Phase 3

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 237 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Long-term Extension, Multicentre, Multi-international Study to Evaluate the Safety and Tolerability of Oral BAY63-2521 (1mg, 1.5 mg, 2.0 mg, 2.5 mg Tid) in Patients With Chronic Thromboembolic Pulmonary Hypertension (CTEPH).
Actual Study Start Date : July 1, 2009
Actual Primary Completion Date : August 19, 2019
Actual Study Completion Date : August 19, 2019


Arm Intervention/treatment
Experimental: Arm 1 Drug: Riociguat (Adempas, BAY63-2521)
BAY63-2521 - 1 mg tid - 2,5 mg tid orally until end of study




Primary Outcome Measures :
  1. Number of Participants With Treatment-emergent Adverse Events (TEAE) [ Time Frame: From administration of first dose of study medication up to 2 days after end of treatment with study medication, up to 10 years ]
    Analyses of drug-related TEAEs were based on the assessment of causal relationship to study medication.

  2. Number of Participants With Death [ Time Frame: From baseline to end of safety follow-up visit, up to 10 years (1 month more than End of study visit) ]
    Analyses of deaths were based on the assessment of causal relationship to study medication. The safety follow-up visit was to be performed 30 days after the last dose of riociguat.


Secondary Outcome Measures :
  1. Percentage of Participants With Treatment-emergent High Laboratory Abnormalities in Hematology and Coagulation [ Time Frame: From baseline to Termination visit, up to 10 years ]
    Frequency of participants only with a treatment-emergent shift in hematology and coagulation parameters from normal or low at baseline to a high value at a timepoint after the start of treatment. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  2. Percentage of Participants With Treatment-emergent Low Laboratory Abnormalities in Hematology and Coagulation [ Time Frame: From baseline to Termination visit, up to 10 years ]
    Frequency of participants only with a treatment-emergent shift in hematology and coagulation parameters from normal or high at baseline to a low value at a timepoint after the start of treatment. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  3. Change From Baseline of Hemoglobin in Hematology and Coagulation [ Time Frame: From baseline to Termination visit, up to 10 years ]
    Hemoglobin is standard Hematology and coagulation parameter. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  4. Percentage of Participants With Treatment-emergent High Laboratory Abnormalities in Clinical Chemistry [ Time Frame: From baseline to Termination visit, up to 10 years ]
    Frequency of participants per treatment group only with a treatment-emergent shift in clinical chemistry parameters from normal or low at baseline to a high value at a timepoint after the start of treatment. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  5. Percentage of Participants With Treatment-emergent Low Laboratory Abnormalities in Clinical Chemistry [ Time Frame: From baseline to Termination visit, up to 10 years ]
    Frequency of participants per treatment group only with a treatment-emergent shift in clinical chemistry parameters from normal or high at baseline to a low value at a timepoint after the start of treatment. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  6. Change From Baseline of Urate in Clinical Chemistry [ Time Frame: From baseline to Termination visit, up to 10 years ]
    Urate is standard clinical chemistry parameter. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.


Other Outcome Measures:
  1. Change of Systolic Blood Pressure (SBP) [ Time Frame: From baseline to Termination visit, up to 10 years ]
    SBP was measured after the participant had been at rest for 10 minutes in a supine position. Low SBP was defined as SBP <95 mmHg, normal SBP as SBP 95-140mmHg, and high SBP as SBP >140 mmHg. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  2. Change of Diastolic Blood Pressure (DBP) [ Time Frame: From baseline to Termination visit, up to 10 years ]
    DBP was measured after the participants had been at rest for 10 minutes in a supine position. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  3. Change of Heart Rate [ Time Frame: From baseline to Termination visit, up to 10 years ]
    Heart rate was measured after the participant had been at rest for 10 minutes in a supine position. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  4. Change of Weight [ Time Frame: From baseline to Termination visit, up to 10 years ]
    Weight was evaluated for safety. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  5. Change of Oxygen Saturation (SaO2) [ Time Frame: From baseline to Termination visit, up to 10 years ]
    SaO2 is one parameters of blood gas. The sample was obtained with the participant resting in a sitting or supine position for at least 10 minutes. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  6. Change of Arterial Partial Oxygen Pressure (PaO2) [ Time Frame: From baseline to Termination visit, up to 10 years ]
    PaO2 is one parameter of blood gas. The sample was obtained with the participant resting in a sitting or supine position for at least 10 minutes. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  7. Change of Arterial Partial Pressure of Carbon Dioxide (PaCO2) [ Time Frame: From baseline to Termination visit, up to 10 years ]
    PaCO2 is one parameter of blood gas. The sample was obtained with the participant resting in a sitting or supine position for at least 10 minutes. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.

  8. Change of RR Duration From Electrocardiogram (ECG) [ Time Frame: From baseline to Month 48 ]
    Heart rate from ECG is derived from the RR duration, unless arrhythmias such as atrial fibrillation or ventricular extra beats require additional calculations. ECGs were recorded after the participant had been at rest for 15 minutes in a supine position. Analyses up to Month 48. After this timepoint, data was available for considerably fewer participants in the analysis set.

  9. Change of PR Duration From ECG [ Time Frame: From baseline to Month 48 ]
    PR duration was evaluated as part of ECG. ECGs were recorded after the participant had been at rest for 15 minutes in a supine position. Analyses up to Month 48. After this timepoint, data was available for considerably fewer participants in the analysis set.

  10. Change of QRS Duration From ECG [ Time Frame: From baseline to Month 48 ]
    QRS duration was evaluated as part of ECG. ECGs were recorded after the participant had been at rest for 15 minutes in a supine position. Analyses up to Month 48. After this timepoint, data was available for considerably fewer participants in the analysis set.

  11. Change of QT Duration in ECG [ Time Frame: From baseline to Month 48 ]
    QT duration was evaluated as part of ECG. ECGs were recorded after the participant had been at rest for 15 minutes in a supine position. Analyses up to Month 48. After this timepoint, data was available for considerably fewer participants in the analysis set.

  12. Change in Six-minute Walking Distance (6MWD) Test [ Time Frame: From baseline to End of study visit, up to 10 years ]
    6MWD is exercise testing and is one of efficacy evaluation

  13. Change in Pulmonary Vascular Resistance (PVR) [ Time Frame: From baseline to Month 45 and Month 48 ]
    Pulmonary vascular resistance (PVR) was measured only if right-heart catheterization was performed as part of a regular diagnostic work-up. Analyses up to Month 48 due to limited data.

  14. Change in N-terminal Prohormone of Brain Natriuretic Peptide (NT-proBNP) [ Time Frame: From baseline to End of study visit, up to 10 years ]
    NT-proBNP levels in the blood are used for diagnosis of acute congestive heart failure (CHF) and may be useful to establish prognosis in heart failure

  15. Change in World Health Organization (WHO) Functional Class [ Time Frame: From baseline to End of study visit, up to 10 years ]
    WHO classification: I: Participants with PH. Ordinary physical activity does not cause undue dyspnea or fatigue, chest pain, or near syncope. II: Participants with PH are comfortable at rest. Ordinary physical activity causes undue dyspnea or fatigue, chest pain, or near syncope. III: Participants with PH are comfortable at rest. Less than ordinary activity causes undue dyspnea or fatigue, chest pain, or near syncope. IV: Participants with PH with inability to carry out any physical activity. They manifest signs of right-heart failure. Dyspnea and/or fatigue may even be present at rest. For class change from baseline, minus indicates a participant's functional class decreased compared with baseline (e.g. "-1" indicates a participant changed from class IV to class III, or from class II to class I), plus indicates a participant's functional class increased compared with baseline (e.g. "+1" indicates a participant changed from class I to class II, or from class III to class IV).

  16. Number of Participants With Clinical Worsening [ Time Frame: From baseline to End of study visit, up to 10 years ]
    Time to clinical worsening was a parameter that combined death and events reflective of persistent clinical worsening of the participant's underlying diagnosis of pulmonary hypertension (PH).

  17. Incidence of Clinical Worsening Events Per 100 Person Years [ Time Frame: From baseline to End of study visit, up to 10 years ]
    Time to clinical worsening was a parameter that combined death and events reflective of persistent clinical worsening of the participant's underlying diagnosis of pulmonary hypertension (PH).

  18. Change From Baseline in Borg CR 10 Scale [ Time Frame: From baseline to Week 12 ]
    The Borg CR10 Scale was measured in conjunction with the 6MWD test. The test was explained to the participant before starting the 6MWD test. Participants were asked to rank their exertion at the end of the 6MWD test. Low values indicate low levels of exertion; high values indicate more intense exertion reported by the participant. The score ranges from 0 ("Nothing at all") to 10 ("Extremely strong - Maximal").

  19. Change in Score of EQ-5D Questionnaire [ Time Frame: From baseline to End of study visit, up to 10 years ]
    The EQ-5D is a standardized instrument for use as a measure of health outcome. The EQ-5D is a self report questionnaire. The utility score is calculated based on five questions concerning problems with mobility, self-care, usual activities, pain/discomfort and anxiety/depression. An increase in the utility score represents an improvement in quality of life. The score ranges from -0.594 (worst answer in all five questions) to 1 (best answer in all five questions).

  20. Change in Score of Living With Pulmonary Hypertension (LPH) Questionnaire [ Time Frame: From baseline to End of study visit, up to 10 years ]
    The LPH questionnaire is designed to measure the effects of PH and PH-specific treatments on an individual's quality of life. The LPH is a self-report questionnaire and was completed by the participant. The LPH total score can range from 0 (best) to 105 (worst).



Information from the National Library of Medicine

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, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients who have completed 16 weeks of treatment in the double blind trial CHEST 1

Exclusion Criteria:

  • Patients who have an ongoing serious adverse event from CHEST 1 that is assessed as related to BAY63-2521 are not allowed to participate in the extension trial

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): NCT00910429


Locations
Show Show 73 study locations
Sponsors and Collaborators
Bayer
Investigators
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Study Director: Bayer Study Director Bayer
  Study Documents (Full-Text)

Documents provided by Bayer:
Study Protocol  [PDF] December 13, 2012
Statistical Analysis Plan  [PDF] July 25, 2019

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Bayer
ClinicalTrials.gov Identifier: NCT00910429    
Other Study ID Numbers: 11349
2008-003539-19 ( EudraCT Number )
First Posted: May 29, 2009    Key Record Dates
Results First Posted: October 22, 2020
Last Update Posted: October 22, 2020
Last Verified: September 2020

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Bayer:
Chronic thromboembolic Hypertension
PH
soluble Guanylate Cyclase Stimulator
sGC
Additional relevant MeSH terms:
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Hypertension, Pulmonary
Hypertension
Vascular Diseases
Cardiovascular Diseases
Lung Diseases
Respiratory Tract Diseases
Riociguat
Enzyme Activators
Molecular Mechanisms of Pharmacological Action