Clinical Investigation Into Inhaled Treprostinil Sodium in Patients With Severe Pulmonary Arterial Hypertension (PAH) (TRIUMPH)

United Therapeutics

Status and phase

Completed

Phase 3

Conditions

Pulmonary Hypertension

Treatments

Drug: Inhaled treprostinil

Drug: Placebo inhalation solution

Study type

Interventional

Funder types

Industry

Identifiers

NCT00147199

LRX-TRIUMPH 001

Details and patient eligibility

About

This is a double-blind placebo-controlled clinical investigation into the efficacy and tolerability of inhaled treprostinil in patients with severe pulmonary arterial hypertension. The primary outcome is the change in 6-minute walk distance from baseline to week 12.

Full description

Patients who have been on a stable dose of 125 mg twice daily (bid) of bosentan or any stable dose of sildenafil for at least three months prior to study start were randomized to either treprostinil inhalation solution or matching placebo.

Administration of study medication was performed by inhalation with the OPTINEB™ ultrasonic nebulizer.

The proposed dosing regimen was four times daily-upon awakening, at midday, evening (dinner time) and bedtime.

After a patient has completed the twelve-week study period, they were given the option of enrolling into an open-label extension study.

Enrollment

235 patients

Sex

All

Ages

18 to 75 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Clinically stable, pulmonary arterial hypertension diagnosed as either idiopathic or familial PAH, collagen vascular disease associated PAH, HIV PAH, or PAH induced by anorexigens, New York Heart Association (NYHA) Class III or Class IV.
Been on a stable dose of 125 mg twice daily (bid) of bosentan OR any stable dose of sildenafil for at least three months prior to study start
An unencouraged six minute walk test (6MWT) of between 200 and 450 meters at screening
Cardiac catheterization within the past 13 months consistent with PAH, specifically mean pulmonary artery pressure (PAPm) ≥25 mmHg (at rest), pulmonary capillary wedge pressure (PCWP) (or left ventricular end diastolic pressure) ≤15 mmHg, and pulmonary vascular resistance (PVR) >3 mmHg/L/min
Within the past 12 months, patients must have had a chest radiograph consistent with the diagnosis of PAH
Willing and able to follow all study procedures

Exclusion criteria

Considering pregnancy, are pregnant and/or lactating
PAH due to conditions other than noted in the above inclusion criteria.
Have had any change in or discontinued any PAH medication within the last three months, including but not limited to endothelin receptor antagonist (ERA), or calcium channel blockers (CCB) (with the exception of anticoagulants)
Have received any prostanoid within the 30 days before screening or are scheduled to receive any during the course of the study
Have received any investigational medication within 30 days prior to the start of this study or are scheduled to receive another investigational drug during the course of this study
Have a known intolerance to any drug, especially to treprostinil sodium or prostanoids
Have an increased risk of hemorrhage
Have a new type of chronic therapy (e.g., a different category of vasodilator, diuretic) for PAH added within the last month, except anticoagulants
Have any musculoskeletal disease or any other disease that would limit ambulation.