E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Modified NYHA class II or III patients with Pulmonary Hypertension (PH), ICD: 416.9 |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 8.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10020787 |
E.1.2 | Term | Hypertension pulmonary |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess efficacy on pulmonary artery pressure after six months of therapy |
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E.2.2 | Secondary objectives of the trial |
To assess clinical, hemodynamic, respiratory, functional and cardiovascular parameters following once daily multiple oral doses of simvastatin for 12 months.
To assess efficacy and tolerability of simvastatin in the treatment of patients with PH compared to placebo for six months.
To assess tolerability of long term once daily multiple oral doses of simvastatin and placebo in PH
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Female and male patients of any racial origin with PH 2. Having fulfilled his/her 18th birthday on Day 1 of the study 3. Modified NYHA functional class II or III 4. PH due to idiopathic pulmonary arterial hypertension or collagen vascular disease associated PH 5. Cardiac catheterization within the last year consistent with PH, specifically PAPm greater equal 25 mmHg (at rest), pulmonary capillary wedge pressure (PCWP) (or left ventricular end diastolic pressure) smaller equal 15 mmHg, and PVR >3 mmHg/L/min 6. Echocardiogram on Day 1 consistent with PH, specifically evidence of right ventricular hypertrophy or dilation, evidence of normal left ventricular function, and absence of mitral valve stenosis 7. Six-minute walk test between 150 and 450 m 8. Patients receiving conventional PH therapy. Stable for one month. 9. Able to understand and willing to sign the Informed Consent Form. 10. Negative pregnancy test (β-HCG) at the start of the trial and appropriate contraception throughout the study for women with child-bearing potential
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E.4 | Principal exclusion criteria |
1. Pregnancy and/or lactation 2. PH of any cause other than permitted in the entry criteria 3. Contraindication for CMR scan or heart catheterization 4. Any change in disease-targeted therapy within the last 4 weeks 5. Patients requiring prostanoid therapy at the start of the study 6. Patients already taking a statin 7. Any subject who had received any investigational medication within 1 month prior to the start of this study or who is scheduled to receive another investigational drug during the course of this study 8. Known intolerance to HMG-CoA-inhibitors (statins) or any of the excipients 9. Active liver disease, porphyria or elevations of serums transaminases >3 x ULN (upper limit of normal) or bilirubin > 1.5 x ULN 10. Concomitant administration of potent CYP3A4 inhibitors (e.g. itraconazole, ketoconazole, HIV protease inhibitors, erythromycin, clarithromycin, telithromycin and nefazodone), ciclosporin and danazole. 11. History or suspicion of inability to cooperate adequately 12. Severe renal insufficiency (serum creatinine level 4.0 mg/dL [354 µmol/L])
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E.5 End points |
E.5.1 | Primary end point(s) |
Pulmonary artery pressure after 6 months of treatment compared to baseline (Day 2) |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Information not present in EudraCT |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
Two phase trial: 1) double blinded (6 months), 2) open (6 months) |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Withdrawal of consent; Investigator's decision; Non-compliance; Intolerable AE; Intercurrent illness; Deterioration of 6-minute walk test (-10% versus baseline) and/or modified NYHA class at Month 3 or 6 versus baseline; Subject entered the study in violation of the protocol or occurrence of a significant protocol violation; Data not known before become available and raise concern about the safety of the study drug so that continuation would pose potential risks to the patients
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | |