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A Open Label Study to Assess the Long-term Safety, Tolerability and Efficacy of Ambrisentan in Subjects With Inoperable Chronic Thromboembolic Pulmonary Hypertension (CTEPH) (AMBER II)

This study has been completed.
Information provided by (Responsible Party):
GlaxoSmithKline Identifier:
First received: July 3, 2013
Last updated: February 18, 2016
Last verified: February 2016

This is an open label, long term extension to Study AMB115811. All subjects may remain in the extension study for a minimum of 18 months. Beyond the 18-month period, subjects may continue in the extension study until one of the following:

  • The product is approved locally for use in inoperable CTEPH patients;
  • Development for use in the CTEPH population is discontinued or product is not approved by the local regulatory authorities
  • The investigator decides to discontinue the subject or subject decides to discontinue from the study.

The primary purpose of this study is to provide clinically relevant information on the long term safety of ambrisentan in subjects with inoperable CTEPH.

Condition Intervention Phase
Drug: Ambrisentan 5 mg
Phase 3

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: An Open-label Extension Study of the Long-term Safety, Tolerability and Efficacy of Ambrisentan in Subjects With Inoperable Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

Resource links provided by NLM:

Further study details as provided by GlaxoSmithKline:

Primary Outcome Measures:
  • Number of subjects with adverse events and serious adverse events [ Time Frame: Up to 3.5 years ]
  • Safety as assessed by clinical laboratory measurements (including liver safety and haematological parameters) [ Time Frame: Up to 3.5 years ]
    Clinical laboratory measurements will include liver safety and haematological parameters

  • Safety as assessed by physical examination [ Time Frame: Up to 3.5 years ]
    Physical examination will be done to assess weight, jugular venous pressure, liver size, peripheral oedema, ascites and signs of deep vein thrombosis

  • Safety as assessed by vital Signs measurements [ Time Frame: Up to 3.5 years ]
    Vital signs including heart rate and supine blood pressure, and weight will be collected at each clinic visit.

  • The time to change in dosing of Ambrisentan or other PAH therapeutic agent [ Time Frame: Up to 3.5 years ]
    Other targeted Pulmonary arterial hypertension (PAH) therapeutic agents include prostanoids, Phosphodiesterase type 5 (PDE-5) inhibitors; and tolerability issues include e.g. adverse events.

Secondary Outcome Measures:
  • 6 minute walking distance (6MWD) test [ Time Frame: Up to 3.5 years ]
    The 6MWD measures the distance an individual is able to walk over a total of six minutes on a hard, flat surface.

  • World Health Organisation (WHO) functional class [ Time Frame: Up to 3.5 years ]
    WHO functional class will be determined every three months for the first 18 months, and at the time the subject exits the study.

  • Borg CR10 Scale (BCR10S) [ Time Frame: Up to 3.5 years ]
    The BCR10S is a method for measuring perceived exertion and effort in physical work. The BCR10S will be performed straight after every 6MWD test for the first 18 months (every three months during the first 18 months, and at the time the subject exits the study).

  • Clinical worsening of CTEPH [ Time Frame: First 18 months of the study ]
    Clinical worsening of CTEPH is defined as defined by the time from randomization to the first occurrence of death, lung transplantation, hospitalization for worsening CTEPH, atrial septostomy, addition of parenteral prostanoids and appearance of two or more CTEPH worsening events

  • Time to addition of another targeted PAH therapeutic agents [ Time Frame: Up to 3.5 years ]
    Addition of another targeted PAH therapeutics agents is defined as addition of other PAH agents due to deterioration of clinical condition and lack of beneficial effect with previous therapy (not reaching set treatment goals).

  • Change in dose of ambrisentan or other targeted PAH therapeutic agents [ Time Frame: Up to 3.5 years ]
    Change in dose of ambrisentan or other targeted PAH therapeutic agents (prostanoids, PDE-5 inhibitors) is defined as a dose change due to deterioration of clinical condition.

  • Subject Global Assessment using the Short Form 36 Health Survey (SF-36) [ Time Frame: Up to 3.5 years ]
    Subject Global assessments (SF-36 short form) will be performed every three months for the first 18 months, and at the time the subject exits the study. The SF-36 Health Survey asks 36 questions to measure functional health and well-being from the subject's point of view.

  • N-terminal pro-B-type natriuretic peptide (NT-Pro BNP) concentration [ Time Frame: first 18 months or early withdrawal ]
    Blood samples for determination of NT-Pro BNP plasma concentrations will be collected every three months for the first 18 months or early withdrawal.

Enrollment: 17
Study Start Date: January 2014
Study Completion Date: November 2015
Primary Completion Date: November 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Ambrisentan Arm
All subjects will receive ambrisentan initially at a dose of 5 mg once daily (OD). Based on the investigator's best judgment, the subject may continue on 5 mg OD, or be up-titrated to 10 mg OD. The dose may also be adjusted back to 5 mg OD at investigator discretion.
Drug: Ambrisentan 5 mg
Round, white, film-coated, immediate-release tablets, containing 5 mg ambrisentan. Subjects will be dosed orally once daily. Subjects may receive 5mg, or 10 mg of ambrisentan OD.


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

Inclusion Criteria:

  • Have been randomized to the protocol for AMB115811 and have met one of the following: Completed the Week 16 visit in AMB115811; Or Prematurely withdrew from AMB115811 for whatever reason (where investigational product [IP] has been stopped due to safety or efficacy reasons, the subject may still enter into the open label study regardless of what treatment they are receiving [other treatments will not be supplied by the sponsor]. The investigator will decide whether or not the subject will receive the IP
  • Subject is able and willing to give written informed consent. As part of the consent, female subjects of childbearing potential will be informed of the risk of teratogenicity and will need to be counseled in a developmentally appropriate manner on the importance of pregnancy prevention; and male subjects will need to be informed of potential risk of testicular tubular atrophy and aspermia.
  • Specific information regarding warnings, precautions, contraindications, adverse events, and other pertinent information on the GSK investigational product or other study treatment that may impact subject eligibility is provided in the Investigators Brochure and product label for PAH indication.
  • In France, a subject will be eligible for inclusion in this study only if either affiliated to or a beneficiary of a social security category

Exclusion Criteria:

  • Subject meeting any of the following criteria must not receive ambrisentan, however may still be followed-up as part of the study and be treated according to best clinical practice as decided by the investigator:
  • Subject has a known hypersensitivity to the Investigational Products, the metabolites, or formulation excipients
  • Female subjects who are pregnant or breastfeeding or no-longer agree to comply with using effective contraception as defined in the protocol.
  • Subjects with alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) >= 3x Upper limit of normal (ULN)
  • Subjects with bilirubin >= 2xULN (>35% direct bilirubin)
  • Subjects with severe renal impairment (estimated creatinine clearance <30 millilitre per minute (mL/min) assessed within the previous 45 days) at the point of transition from Study AMB115811
  • Subject has moderate - severe hepatic impairment (Child-Pugh class B-C with or without cirrhosis) at the point of transition from study AMB115811
  • Subject with clinically significant fluid retention in the opinion of the investigator
  • Subject with clinically significant anemia in the opinion of the investigator
  • Subjects who are to enter another clinical trial or be treated with another investigational product after exiting Study AMB115811.
  Contacts and Locations
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Please refer to this study by its identifier: NCT01894022

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Sponsors and Collaborators
Study Director: GSK Clinical Trials GlaxoSmithKline
  More Information

Responsible Party: GlaxoSmithKline Identifier: NCT01894022     History of Changes
Other Study ID Numbers: 116457
Study First Received: July 3, 2013
Last Updated: February 18, 2016

Keywords provided by GlaxoSmithKline:
Inoperable chronic thromboembolic pulmonary hypertension, endothelin receptor antagonist

Additional relevant MeSH terms:
Hypertension, Pulmonary
Vascular Diseases
Cardiovascular Diseases
Lung Diseases
Respiratory Tract Diseases
Endothelin Receptor Antagonists
Molecular Mechanisms of Pharmacological Action processed this record on May 25, 2017