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    Clinical Trial Results:
    An Extended Access Program to Assess Long-Term Safety of Bardoxolone Methyl in Patients with Pulmonary Hypertension

    Summary
    EudraCT number
    2016-004365-16
    Trial protocol
    ES   BE   CZ   GB   DE  
    Global end of trial date
    30 Sep 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    17 Oct 2021
    First version publication date
    17 Oct 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    402-C-1602
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03068130
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Reata Pharmaceuticals
    Sponsor organisation address
    5320 Legacy Drive, Plano, United States, 75024
    Public contact
    Clinical Study Manager, Reata Pharmaceuticals, Inc., 972 8652219, 408C1602DNK@reatapharma.com
    Scientific contact
    Clinical Study Manager, Reata Pharmaceuticals, Inc., 972 8652219, 408C1602DNK@reatapharma.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
    03 Aug 2021
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    30 Sep 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Sep 2020
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    This extended access (open label) study will assess the long-term safety and tolerability of bardoxolone methyl in qualified patients with pulmonary hypertension (PH) who previously participated in controlled clinical studies with bardoxolone methyl. Qualified patients will receive 10 mg of bardoxolone methyl once daily until the drug is available through commercial channels or until patient withdrawal, whichever is sooner. Dose de-escalation (down to 5 mg) is permitted during the study, if indicated clinically.
    Protection of trial subjects
    The study sites will be monitored remotely by the CRO periodically during the study to ensure that all aspects of the protocol will be followed and will include an electronic data collection which has a set of automatic data checks with data queries for programmed data collection. There will be monitoring of study site by telephone to ensure that the drug supplies have been provided and protocol instructions are well understood and applied. The Sponsor or designee will monitor all aspects of the study for compliance with applicable government regulation with respect to the International Council for Harmonisation (ICH) guideline E6(R1): Good Clinical Practice: Consolidated Guideline and current standard operating procedures.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    18 Apr 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
    Netherlands: 2
    Country: Number of subjects enrolled
    Spain: 8
    Country: Number of subjects enrolled
    United Kingdom: 3
    Country: Number of subjects enrolled
    Belgium: 3
    Country: Number of subjects enrolled
    Czechia: 3
    Country: Number of subjects enrolled
    Germany: 4
    Country: Number of subjects enrolled
    Argentina: 23
    Country: Number of subjects enrolled
    Australia: 13
    Country: Number of subjects enrolled
    Brazil: 4
    Country: Number of subjects enrolled
    Canada: 6
    Country: Number of subjects enrolled
    Israel: 3
    Country: Number of subjects enrolled
    Japan: 12
    Country: Number of subjects enrolled
    Mexico: 11
    Country: Number of subjects enrolled
    Philippines: 5
    Country: Number of subjects enrolled
    United States: 161
    Worldwide total number of subjects
    261
    EEA total number of subjects
    20
    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)
    171
    From 65 to 84 years
    90
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Treatment-compliant patients who are participating in qualifying ongoing studies and have completed required End-of-Treatment and/or Follow-up visits in a prior clinical study with bardoxolone methyl.

    Pre-assignment
    Screening details
    This is an extended access (Open label) study assessing the long-term safety and tolerability of bardoxolone methyl in patients with PH who previously participated in qualifying clinical studies 402-C-1504 and 402-C-1302 (also referred to as previous qualifying studies of Study 1602) with bardoxolone methyl. All patients received bardoxolone methyl

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Experimental: Bardoxolone Methyl 10 mg
    Arm description
    Bardoxolone methyl administered orally once daily at 10 mg until it becomes commercially available. Dose de-escalation (down to 5 mg) is permitted during the study, if indicated clinically.
    Arm type
    Experimental

    Investigational medicinal product name
    Bardoxolone methyl capsules 10mg
    Investigational medicinal product code
    RTA 402
    Other name
    BARDOXOLONE METHYL, CDDO-Me, CDDO-Methyl Ester, NSC 713200, Chemical Name: Oleana-1,9(11)-dien-28-oic acid, 2-cyano-3,12-dioxo-, methyl ester
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Bardoxolone methyl administered orally once daily at 10 mg until it becomes commercially available. Dose de-escalation (down to 5 mg) is permitted during the study, if indicated clinically.

    Number of subjects in period 1
    Experimental: Bardoxolone Methyl 10 mg
    Started
    261
    Completed
    0
    Not completed
    261
         Adverse event, serious fatal
    14
         Administrative Reasons
    3
         Consent withdrawn by subject
    26
         Adverse event, non-fatal
    19
         Protocol Specified Withdrawal Criterion
    1
         Study Terminated by Sponsor
    194
         Lost to follow-up
    4

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall Study
    Reporting group description
    -

    Reporting group values
    Overall Study Total
    Number of subjects
    261 261
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Experimental: Bardoxolone methyl will be administered orally once daily at 10 mg until it becomes commercially available. Dose de-escalation (down to 5 mg) is permitted during the study, if indicated clinically.
    Units: years
        arithmetic mean (standard deviation)
    56.7 ± 12.79 -
    Gender categorical
    Bardoxolone methyl will be administered orally once daily at 10 mg until it becomes commercially available. Dose de-escalation (down to 5 mg) is permitted during the study, if indicated clinically.
    Units: Subjects
        Female
    221 221
        Male
    40 40
    Ethnic Group
    Experimental: Bardoxolone methyl will be administered orally once daily at 10 mg until it becomes commercially available. Dose de-escalation (down to 5 mg) is permitted during the study, if indicated clinically.
    Units: Subjects
        American Indian or Alaska Native
    0 0
        Asian
    22 22
        Native Hawaiian or Pacific Islander
    0 0
        Black or African American
    30 30
        More than one race
    204 204
        Unknown or Not Reported
    5 5

    End points

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    End points reporting groups
    Reporting group title
    Experimental: Bardoxolone Methyl 10 mg
    Reporting group description
    Bardoxolone methyl administered orally once daily at 10 mg until it becomes commercially available. Dose de-escalation (down to 5 mg) is permitted during the study, if indicated clinically.

    Primary: Long term safety as measured by incidence and severity of adverse events during the duration of the study

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    End point title
    Long term safety as measured by incidence and severity of adverse events during the duration of the study [1]
    End point description
    Severity was defined using the following definitions: Mild: Symptoms causing no or minimal interference with usual social and functional activities; Moderate: Symptoms causing greater than minimual interference with usual social and functional activities; Severe: Symptoms causing inability to perform usual social and functional activities.
    End point type
    Primary
    End point timeframe
    From time of first dose until the final visit, up to 172 weeks
    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: This extended access (open label) study assessed the long-term safety and tolerability of bardoxolone methyl in qualified patients with pulmonary hypertension (PH) who previously participated in controlled clinical studies with bardoxolone methyl. The Primary endpoint was long term safety as measured by incidence and severity of adverse events during the duration of the study. As such, no additional statistical analysis was performed.
    End point values
    Experimental: Bardoxolone Methyl 10 mg
    Number of subjects analysed
    261
    Units: Count of Participants
    number (not applicable)
        Number of subjects with at least one AE
    232
        Number of subjects with a related AE
    89
        Number of subjects with a serious AE
    106
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    The time from the date of a participant's first dose to his or her last participation or event date, a maximum of 172 weeks
    Adverse event reporting additional description
    All AEs/SAEs from the time of admin of the first dose until final visit were to be reported. AEs/SAEs occurring within 30 days after last dose were considered treatment emergent. For SAEs, the PI was to follow the patient until the SAE subsided or until the condition became chronic in nature, stabilized (persistent impairment) or the patient died.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.0
    Reporting groups
    Reporting group title
    Experimental: Bardoxolone Methyl 10 mg
    Reporting group description
    Bardoxolone methyl administered orally once daily at 10 mg until it becomes commercially available. Dose de-escalation (down to 5 mg) is permitted during the study, if indicated clinically.

    Serious adverse events
    Experimental: Bardoxolone Methyl 10 mg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    106 / 261 (40.61%)
         number of deaths (all causes)
    17
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Intraductal proliferative breast lesion
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Invasive ductal breast carcinoma
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Salivary gland cancer
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Squamous cell carcinoma
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Squamous cell carcinoma of lung
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Vascular disorders
    Haematoma
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Shock
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombophlebitis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Complication associated with device
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Device related thrombosis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Non-cardiac chest pain
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Menometrorrhagia
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ovarian cyst ruptured
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Acute respiratory failure
         subjects affected / exposed
    4 / 261 (1.53%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 2
    Asthma
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea exertional
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Interstitial lung disease
         subjects affected / exposed
    3 / 261 (1.15%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Pulmonary arterial hypertension
         subjects affected / exposed
    13 / 261 (4.98%)
         occurrences causally related to treatment / all
    2 / 16
         deaths causally related to treatment / all
    1 / 2
    Pulmonary embolism
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary hypertension
         subjects affected / exposed
    5 / 261 (1.92%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 1
    Pulmonary oedema
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory failure
         subjects affected / exposed
    3 / 261 (1.15%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Norovirus test positive
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Weight decreased
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypomagnesaemia
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Accidental overdose
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cervical vertebral fracture
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Drug administration error
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Environmental exposure
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Eschar
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Joint injury
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Laceration
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thoracic vertebral fracture
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Angina unstable
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Arteriosclerosis coronary artery
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Atrial flutter
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure
         subjects affected / exposed
    4 / 261 (1.53%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 2
    Cardiac failure acute
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Cardiac failure congestive
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Cardio-respiratory arrest
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Cardiogenic shock
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Coronary artery occlusion
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dilatation ventricular
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Left ventricular failure
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Palpitations
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    3 / 261 (1.15%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Pericarditis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Right ventricular dysfunction
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Right ventricular failure
         subjects affected / exposed
    7 / 261 (2.68%)
         occurrences causally related to treatment / all
    2 / 10
         deaths causally related to treatment / all
    0 / 1
    Systolic dysfunction
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cerebellar artery thrombosis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Embolic stroke
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Headache
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatic encephalopathy
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lateral medullary syndrome
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Lumbar radiculopathy
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolic encephalopathy
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Paraesthesia
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Presyncope
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Spinal epidural haematoma
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Subarachnoid haemorrhage
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Syncope
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Vasculitis cerebral
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Agranulocytosis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Anaemia
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Iron deficiency anaemia
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Ascites
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Colitis ischaemic
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dental cyst
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Duodenitis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Dysphagia
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Faecaloma
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastritis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    3 / 261 (1.15%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemorrhoids thrombosed
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Mallory-Weiss syndrome
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oesophageal motility disorder
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oesophageal stenosis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholelithiasis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary retention
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Bursitis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Costochondritis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal pain
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myalgia
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Osteoarthritis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Scleroderma
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal deformity
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Systemic lupus erythematosus
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Atypical pneumonia
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bacteraemia
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bursitis infective
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    4 / 261 (1.53%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Cellulitis staphylococcal
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea infectious
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ecthyma
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemophilus infection
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Infectious colitis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Influenza
         subjects affected / exposed
    4 / 261 (1.53%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Meningitis
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    13 / 261 (4.98%)
         occurrences causally related to treatment / all
    0 / 13
         deaths causally related to treatment / all
    0 / 0
    Pneumonia staphylococcal
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory tract infection viral
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    3 / 261 (1.15%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Septic shock
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Upper respiratory tract infection
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    2 / 261 (0.77%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dehydration
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fluid overload
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Malnutrition
         subjects affected / exposed
    1 / 261 (0.38%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 2%
    Non-serious adverse events
    Experimental: Bardoxolone Methyl 10 mg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    198 / 261 (75.86%)
    Vascular disorders
    Hypotension
         subjects affected / exposed
    12 / 261 (4.60%)
         occurrences all number
    12
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    6 / 261 (2.30%)
         occurrences all number
    6
    Fatigue
         subjects affected / exposed
    19 / 261 (7.28%)
         occurrences all number
    19
    Non-cardiac chest pain
         subjects affected / exposed
    10 / 261 (3.83%)
         occurrences all number
    10
    Oedema peripheral
         subjects affected / exposed
    16 / 261 (6.13%)
         occurrences all number
    169
    Pyrexia
         subjects affected / exposed
    8 / 261 (3.07%)
         occurrences all number
    8
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    25 / 261 (9.58%)
         occurrences all number
    25
    Dyspnoea
         subjects affected / exposed
    25 / 261 (9.58%)
         occurrences all number
    25
    Dyspnoea exertional
         subjects affected / exposed
    7 / 261 (2.68%)
         occurrences all number
    7
    Epistaxis
         subjects affected / exposed
    9 / 261 (3.45%)
         occurrences all number
    9
    Nasal congestion
         subjects affected / exposed
    6 / 261 (2.30%)
         occurrences all number
    6
    Oropharyngeal pain
         subjects affected / exposed
    8 / 261 (3.07%)
         occurrences all number
    8
    Pulmonary arterial hypertension
         subjects affected / exposed
    9 / 261 (3.45%)
         occurrences all number
    9
    Pulmonary hypertension
         subjects affected / exposed
    7 / 261 (2.68%)
         occurrences all number
    7
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    8 / 261 (3.07%)
         occurrences all number
    8
    Investigations
    Brain natriuretic peptide increased
         subjects affected / exposed
    6 / 261 (2.30%)
         occurrences all number
    6
    N-terminal prohormone brain natriuretic peptide increased
         subjects affected / exposed
    21 / 261 (8.05%)
         occurrences all number
    21
    Weight decreased
         subjects affected / exposed
    16 / 261 (6.13%)
         occurrences all number
    16
    Injury, poisoning and procedural complications
    Arthropod bite
         subjects affected / exposed
    6 / 261 (2.30%)
         occurrences all number
    6
    Cardiac disorders
    Palpitations
         subjects affected / exposed
    12 / 261 (4.60%)
         occurrences all number
    12
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    22 / 261 (8.43%)
         occurrences all number
    22
    Headache
         subjects affected / exposed
    26 / 261 (9.96%)
         occurrences all number
    26
    Syncope
         subjects affected / exposed
    9 / 261 (3.45%)
         occurrences all number
    9
    Blood and lymphatic system disorders
    Iron deficiency anaemia
         subjects affected / exposed
    14 / 261 (5.36%)
         occurrences all number
    14
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    10 / 261 (3.83%)
         occurrences all number
    10
    Constipation
         subjects affected / exposed
    11 / 261 (4.21%)
         occurrences all number
    11
    Diarrhoea
         subjects affected / exposed
    41 / 261 (15.71%)
         occurrences all number
    41
    Gastrooesophageal reflux disease
         subjects affected / exposed
    13 / 261 (4.98%)
         occurrences all number
    13
    Nausea
         subjects affected / exposed
    31 / 261 (11.88%)
         occurrences all number
    31
    Vomiting
         subjects affected / exposed
    12 / 261 (4.60%)
         occurrences all number
    12
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    7 / 261 (2.68%)
         occurrences all number
    7
    Skin ulcer
         subjects affected / exposed
    7 / 261 (2.68%)
         occurrences all number
    7
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    13 / 261 (4.98%)
         occurrences all number
    13
    Back pain
         subjects affected / exposed
    13 / 261 (4.98%)
         occurrences all number
    13
    Muscle spasms
         subjects affected / exposed
    33 / 261 (12.64%)
         occurrences all number
    33
    Musculoskeletal pain
         subjects affected / exposed
    9 / 261 (3.45%)
         occurrences all number
    9
    Myalgia
         subjects affected / exposed
    13 / 261 (4.98%)
         occurrences all number
    13
    Neck pain
         subjects affected / exposed
    9 / 261 (3.45%)
         occurrences all number
    9
    Pain in extremity
         subjects affected / exposed
    17 / 261 (6.51%)
         occurrences all number
    17
    Pain in jaw
         subjects affected / exposed
    7 / 261 (2.68%)
         occurrences all number
    7
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    21 / 261 (8.05%)
         occurrences all number
    21
    Cellulitis
         subjects affected / exposed
    8 / 261 (3.07%)
         occurrences all number
    8
    Conjunctivitis
         subjects affected / exposed
    10 / 261 (3.83%)
         occurrences all number
    10
    Herpes zoster
         subjects affected / exposed
    9 / 261 (3.45%)
         occurrences all number
    9
    Influenza
         subjects affected / exposed
    14 / 261 (5.36%)
         occurrences all number
    14
    Lower respiratory tract infection
         subjects affected / exposed
    8 / 261 (3.07%)
         occurrences all number
    8
    Nasopharyngitis
         subjects affected / exposed
    13 / 261 (4.98%)
         occurrences all number
    13
    Pneumonia
         subjects affected / exposed
    11 / 261 (4.21%)
         occurrences all number
    11
    Respiratory tract infection
         subjects affected / exposed
    9 / 261 (3.45%)
         occurrences all number
    9
    Sinusitis
         subjects affected / exposed
    22 / 261 (8.43%)
         occurrences all number
    22
    Upper respiratory tract infection
         subjects affected / exposed
    51 / 261 (19.54%)
         occurrences all number
    51
    Urinary tract infection
         subjects affected / exposed
    30 / 261 (11.49%)
         occurrences all number
    30
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    15 / 261 (5.75%)
         occurrences all number
    15
    Hypokalaemia
         subjects affected / exposed
    13 / 261 (4.98%)
         occurrences all number
    13
    Hypomagnesaemia
         subjects affected / exposed
    7 / 261 (2.68%)
         occurrences all number
    7
    Vitamin D deficiency
         subjects affected / exposed
    6 / 261 (2.30%)
         occurrences all number
    6

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    27 Oct 2016
    Protocol Version 1.0
    05 Jan 2017
    Protocol Version 2.0
    05 Jan 2017
    Protocol Version 2.1 (Japan)
    01 Mar 2017
    Protocol Version 2.2 (Japan)
    09 May 2017
    Protocol Version 2.1 (UK)
    23 Jun 2017
    Protocol Version 2.2 (Germany)
    16 Jul 2018
    Protocol Version 3.0
    16 Jul 2018
    Protocol Version 3.1 (UK)
    16 Jul 2018
    Protocol Version 3.1 (Germany)
    25 Jul 2018
    Protocol Version 3.1 (Japan)
    11 Jul 2019
    Protocol Version 3.2 (Germany)

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    30 Sep 2020
    Due to the COVID-19 pandemic and consideration of the risk of severe adverse outcomes associated with COVID-19 among patients with respiratory and autoimmune diseases, and on recommendation from the parent study’s DSMB (402-C-1504), the Sponsor decided to stop the Phase 3 Study (1504) in patients with CTD-PAH. Patients with CTD-PAH have compromised cardiopulmonary function, are often receiving immunosuppressants, and are at an inherently high risk of adverse outcomes in the event of infection. The Sponsor concluded that continued exposure of these high-risk patients to clinic or in-person visits presented an unacceptable risk. The 1504 parent study was not stopped as a result of any bardoxolone methyl-related safety concern, and the DSMB did not reported any treatment-related safety concerns. There were no deaths in the bardoxolone methyl arm of study 1504, and fewer patients reported serious adverse events (SAE) in the bardoxolone methyl arm compared to the placebo arm within the 1504 study. While no futility analyses were performed, an initial review of available efficacy data provided by the DSMB suggested that Study 1504 was unlikely to meet the primary endpoint of improvement in 6MWD compared to placebo at Week 24. Concomitant with the decision to close Study 1504, the Sponsor also closed Study this study 402-C-1602.
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Early termination of this study due to COVID-19 Pandemic and in consideration of the risk of severe adverse outcomes associated with COVID-19 among patients with respiratory and autoimmune diseases.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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