Clinical Trial Results:
A multicenter, open-label, single-sequence, cross-over study to assess safety, tolerability, and pharmacokinetics of intravenous selexipag in subjects with stable pulmonary arterial hypertension switching from an oral stable dose of selexipag
Summary
|
|
EudraCT number |
2016-004035-21 |
Trial protocol |
DE |
Global end of trial date |
29 May 2018
|
Results information
|
|
Results version number |
v1(current) |
This version publication date |
03 May 2019
|
First version publication date |
03 May 2019
|
Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
|
|||
Trial identification
|
|||
Sponsor protocol code |
AC-065A309
|
||
Additional study identifiers
|
|||
ISRCTN number |
- | ||
US NCT number |
NCT03187678 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
|
|||
Sponsor organisation name |
Actelion Pharmaceuticals Ltd
|
||
Sponsor organisation address |
Gewerbestrasse 16, Allschwil, Switzerland, 4123
|
||
Public contact |
Clinical trial disclosure deck, Actelion Pharmaceuticals Ltd, clinical-trials-disclosure@its.jnj.com
|
||
Scientific contact |
Clinical trial disclosure deck, Actelion Pharmaceuticals Ltd, clinical-trials-disclosure@its.jnj.com
|
||
Paediatric regulatory details
|
|||
Is trial part of an agreed paediatric investigation plan (PIP) |
No
|
||
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
|
||
Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
|
||
Results analysis stage
|
|||
Analysis stage |
Final
|
||
Date of interim/final analysis |
02 Jul 2018
|
||
Is this the analysis of the primary completion data? |
Yes
|
||
Primary completion date |
29 May 2018
|
||
Global end of trial reached? |
Yes
|
||
Global end of trial date |
29 May 2018
|
||
Was the trial ended prematurely? |
No
|
||
General information about the trial
|
|||
Main objective of the trial |
The primary objective of this study was to assess whether it was safe for patients with PAH to temporarily change from selexipag tablets (Uptravi®) to selexipag given intravenously, and then switching back to the initial oral dose of selexipag.
|
||
Protection of trial subjects |
The study was designed and conducted in compliance with International Good clinical Practice (ICH-GCP) Guidelines, the ethical principles of the Declaration of Helsinki and with the laws and regulations of the countries in which the study was conducted.
|
||
Background therapy |
PAH-specific therapies (i.e., ERA, PDE-5 inhibitor, or sGC stimulator) were allowed if subjects were on a stable dose. Uptravi was a mandatory background therapy for participation in this study. Uptravi was to be prescribed as part of the subjects standard therapy and had to be temporarily interrupted during intravenous (iv) selexipag administration. | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
04 Dec 2017
|
||
Long term follow-up planned |
No
|
||
Independent data monitoring committee (IDMC) involvement? |
No
|
||
Population of trial subjects
|
|||
Number of subjects enrolled per country |
|||
Country: Number of subjects enrolled |
Germany: 13
|
||
Country: Number of subjects enrolled |
United States: 7
|
||
Worldwide total number of subjects |
20
|
||
EEA total number of subjects |
13
|
||
Number of subjects enrolled per age group |
|||
In utero |
0
|
||
Preterm newborn - gestational age < 37 wk |
0
|
||
Newborns (0-27 days) |
0
|
||
Infants and toddlers (28 days-23 months) |
0
|
||
Children (2-11 years) |
0
|
||
Adolescents (12-17 years) |
0
|
||
Adults (18-64 years) |
15
|
||
From 65 to 84 years |
5
|
||
85 years and over |
0
|
|
|||||||
Recruitment
|
|||||||
Recruitment details |
- | ||||||
Pre-assignment
|
|||||||
Screening details |
Twenty-two patients treated with Uptravi for pulmonary arterial hypertension (PAH) were screened. Twenty of them were enrolled in the study. | ||||||
Period 1
|
|||||||
Period 1 title |
Period 1 (oral selexipag)
|
||||||
Is this the baseline period? |
Yes | ||||||
Allocation method |
Non-randomised - controlled
|
||||||
Blinding used |
Not blinded | ||||||
Arms
|
|||||||
Arm title
|
Selexipag | ||||||
Arm description |
Subjects treated with a stable dose of oral selexipag (Uptravi) between 200 and 1600 ug twice daily continued to take Uptravi at their prescribed dose during Period 1 (Day 1), then they were switched to intravenous (iv) selexipag during period 2 (3 doses, Day 2 & Day 3) and back to Uptravi during Period 3. | ||||||
Arm type |
Experimental | ||||||
Investigational medicinal product name |
Oral selexipag (Uptravi®)
|
||||||
Investigational medicinal product code |
ACT-293987
|
||||||
Other name |
|||||||
Pharmaceutical forms |
Film-coated tablet
|
||||||
Routes of administration |
Oral use
|
||||||
Dosage and administration details |
Uptravi was used as an auxiliary medicinal product, as part of the PAH standard treatment and according to the local prescribing information.
|
||||||
|
|||||||
Period 2
|
|||||||
Period 2 title |
Period 2 (intravenous selexipag)
|
||||||
Is this the baseline period? |
No | ||||||
Allocation method |
Not applicable
|
||||||
Blinding used |
Not blinded | ||||||
Arms
|
|||||||
Arm title
|
Selexipag | ||||||
Arm description |
Subjects treated with a stable dose of oral selexipag (Uptravi) between 200 and 1600 ug twice daily continued to take Uptravi at their prescribed dose during Period 1 (Day 1), then they were switched to intravenous (iv) selexipag during period 2 (3 doses, Day 2 & Day 3) and back to Uptravi during Period 3. | ||||||
Arm type |
Experimental | ||||||
Investigational medicinal product name |
Intravenous selexipag
|
||||||
Investigational medicinal product code |
ACT-293987
|
||||||
Other name |
|||||||
Pharmaceutical forms |
Powder for infusion
|
||||||
Routes of administration |
Intravenous use
|
||||||
Dosage and administration details |
The intravenous dose was individualized for each subject to correspond to his/her current oral dose of Uptravi® and infused over 87 min.
|
||||||
|
|||||||
Period 3
|
|||||||
Period 3 title |
Period 3 (oral selexipag)
|
||||||
Is this the baseline period? |
No | ||||||
Allocation method |
Not applicable
|
||||||
Blinding used |
Not blinded | ||||||
Arms
|
|||||||
Arm title
|
Selexipag | ||||||
Arm description |
Subjects treated with a stable dose of oral selexipag (Uptravi) between 200 and 1600 ug twice daily continued to take Uptravi at their prescribed dose during Period 1 (Day 1), then they were switched to intravenous (iv) selexipag during period 2 (3 doses, Day 2 & Day 3) and back to Uptravi during Period 3. | ||||||
Arm type |
Experimental | ||||||
Investigational medicinal product name |
Oral selexipag (Uptravi®)
|
||||||
Investigational medicinal product code |
ACT-293987
|
||||||
Other name |
|||||||
Pharmaceutical forms |
Film-coated tablet
|
||||||
Routes of administration |
Oral use
|
||||||
Dosage and administration details |
Uptravi was used as an auxiliary medicinal product, as part of the PAH standard treatment and according to the local prescribing information.
|
||||||
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Baseline characteristics reporting groups
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Selexipag
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects treated with a stable dose of oral selexipag (Uptravi) between 200 and 1600 ug twice daily continued to take Uptravi at their prescribed dose during Period 1 (Day 1), then they were switched to intravenous (iv) selexipag during period 2 (3 doses, Day 2 & Day 3) and back to Uptravi during Period 3. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
End points reporting groups
|
|||
Reporting group title |
Selexipag
|
||
Reporting group description |
Subjects treated with a stable dose of oral selexipag (Uptravi) between 200 and 1600 ug twice daily continued to take Uptravi at their prescribed dose during Period 1 (Day 1), then they were switched to intravenous (iv) selexipag during period 2 (3 doses, Day 2 & Day 3) and back to Uptravi during Period 3. | ||
Reporting group title |
Selexipag
|
||
Reporting group description |
Subjects treated with a stable dose of oral selexipag (Uptravi) between 200 and 1600 ug twice daily continued to take Uptravi at their prescribed dose during Period 1 (Day 1), then they were switched to intravenous (iv) selexipag during period 2 (3 doses, Day 2 & Day 3) and back to Uptravi during Period 3. | ||
Reporting group title |
Selexipag
|
||
Reporting group description |
Subjects treated with a stable dose of oral selexipag (Uptravi) between 200 and 1600 ug twice daily continued to take Uptravi at their prescribed dose during Period 1 (Day 1), then they were switched to intravenous (iv) selexipag during period 2 (3 doses, Day 2 & Day 3) and back to Uptravi during Period 3. | ||
Subject analysis set title |
Safety analysis set
|
||
Subject analysis set type |
Safety analysis | ||
Subject analysis set description |
All enrolled subjects who received at least one dose of Uptravi or intravenous selexipag during any of the study periods
|
||
Subject analysis set title |
iv safety analysis set
|
||
Subject analysis set type |
Safety analysis | ||
Subject analysis set description |
All enrolled subjects who received at least one dose of intravenous selexipag during period 2
|
|
|||||||
End point title |
Number of participants with at least one adverse event (AE) [1] | ||||||
End point description |
AE is any untoward medical event that occurs in a participant during the course of the study whether or not considered by the investigator as related to the study treatment.
|
||||||
End point type |
Primary
|
||||||
End point timeframe |
From Day 1 to Day 37
|
||||||
Notes [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: No formal statistic analyses were performed on these safety data |
|||||||
|
|||||||
No statistical analyses for this end point |
|
|||||||
End point title |
Number of participants with prostacyclin-associated adverse events [2] | ||||||
End point description |
Prostacyclin-associated AE include headache, diarrhea, nausea, vomiting, jaw pain, myalgia, pain in the extremity, flushing and arthralgia.
|
||||||
End point type |
Primary
|
||||||
End point timeframe |
From Day 1 to Day 37
|
||||||
Notes [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: No formal statistic analyses were performed on these safety data. |
|||||||
|
|||||||
No statistical analyses for this end point |
|
|||||||
End point title |
Number of participants with adverse event related to injection site reactions [3] | ||||||
End point description |
This is the number of participants with at least one clinically significant reaction at the injection site (e.g., erythema/redness, tenderness, swelling, induration, hemorrhage at the injection site) occurring on the days of intravenous (iv) selexipag injection.
|
||||||
End point type |
Primary
|
||||||
End point timeframe |
Day 2 and Day 3
|
||||||
Notes [3] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: No formal statistic analyses were performed on these safety data. |
|||||||
|
|||||||
No statistical analyses for this end point |
|
|||||||
End point title |
Number of participants with prostacyclin-associated AEs leading to study treatment discontinuation [4] | ||||||
End point description |
This is the number of subjects who discontinued the i.v. selexipag treatment due to prostacyclin-associated adverse events (headache, diarrhea, nausea, vomiting, jaw pain, myalgia, pain in the extremity, flushing and arthralgia).
|
||||||
End point type |
Primary
|
||||||
End point timeframe |
Day 2 and Day 3
|
||||||
Notes [4] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: No formal statistic analyses were performed on these safety data. |
|||||||
|
|||||||
No statistical analyses for this end point |
|
|||||||
End point title |
Number of participants with PAH-related adverse events [5] | ||||||
End point description |
This is the number of participants with at least one AE considered to be related to pulmonary arterial hypertension during the course of the study.
|
||||||
End point type |
Primary
|
||||||
End point timeframe |
From Day 1 to Day 37
|
||||||
Notes [5] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: No formal statistic analyses were performed on these safety data. |
|||||||
|
|||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse events information
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Timeframe for reporting adverse events |
From Day 2 to Day 37
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse event reporting additional description |
Treatment-emergent AEs are reported, i.e. serious and non-serious AEs starting on or after the first iv infusion of selexipag, which is the investigational treatment.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Assessment type |
Non-systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
21.0
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting groups
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Safety analysis set
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
All enrolled subjects who received at least one dose of Uptravi or intravenous selexipag during any of the study periods | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
Substantial protocol amendments (globally) |
|||
Were there any global substantial amendments to the protocol? No | |||
Interruptions (globally) |
|||
Were there any global interruptions to the trial? No | |||
Limitations and caveats |
|||
Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |