Trial Outcomes & Findings for Evaluate The Clinical Effectiveness, Safety And Tolerability Of Sildenafil Used In Doses ≥20mg TID For The Treatment Of Pulmonary Arterial Hypertension (NCT NCT01365585)

NCT ID: NCT01365585

Last Updated: 2021-02-01

Results Overview

6MWD was the distance that a participant could walk in 6 minutes. Participants were asked to perform the test at a pace that was comfortable to them, with as many breaks as they needed.

Recruitment status

COMPLETED

Target enrollment

227 participants

Primary outcome timeframe

Baseline, Year 1

Results posted on

2021-02-01

Participant Flow

Participant milestones

Participant milestones
Measure
Sildenafil
Participants who received sildenafil greater than or equal to 20 milligram (mg) three times daily as per Summary of Product Characteristics (SmPC) for the treatment of pulmonary arterial hypertension (PAH) for a period of at least 3 months, were observed retrospectively for 5 years.
Overall Study
STARTED
227
Overall Study
COMPLETED
227
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Evaluate The Clinical Effectiveness, Safety And Tolerability Of Sildenafil Used In Doses ≥20mg TID For The Treatment Of Pulmonary Arterial Hypertension

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Sildenafil
n=227 Participants
Participants who received sildenafil greater than or equal to 20 milligram (mg) three times daily as per Summary of Product Characteristics (SmPC) for the treatment of pulmonary arterial hypertension (PAH) for a period of at least 3 months, were observed retrospectively for 5 years.
Age, Continuous
60.5 years
STANDARD_DEVIATION 14.37 • n=93 Participants
Sex/Gender, Customized
Female
145 participants
n=93 Participants
Sex/Gender, Customized
Male
81 participants
n=93 Participants
Six-Minute Walk Distance (6MWD)
331.7 meter
STANDARD_DEVIATION 117.42 • n=93 Participants
New York Heart Association, World Health Organization (NYHA/WHO) Functional Class
Class I
1 participants
n=93 Participants
New York Heart Association, World Health Organization (NYHA/WHO) Functional Class
Class II
39 participants
n=93 Participants
New York Heart Association, World Health Organization (NYHA/WHO) Functional Class
Class III
163 participants
n=93 Participants
New York Heart Association, World Health Organization (NYHA/WHO) Functional Class
Class IV
13 participants
n=93 Participants
Right Atrial Pressure (RAP)
6.6 millimeters of mercury (mmHg)
STANDARD_DEVIATION 4.85 • n=93 Participants
Mean Pulmonary Arterial Pressure (mPAP) at rest
44.8 mmHg
STANDARD_DEVIATION 12.37 • n=93 Participants
Pulmonary Vascular Resistance (PVR)
612.8 dynes*second/centimeter^5
STANDARD_DEVIATION 250.54 • n=93 Participants
Cardiac Index (CI)
2.5 (Liter/minute)/square meter([L/min]/m^2)
STANDARD_DEVIATION 1.51 • n=93 Participants
Pulmonary Capillary Wedge Pressure (PCWP)
7.6 mmHg
STANDARD_DEVIATION 3.84 • n=93 Participants
Borg Dyspnea Index
3.7 units on a scale
STANDARD_DEVIATION 1.91 • n=93 Participants

PRIMARY outcome

Timeframe: Baseline, Year 1

Population: Analysis population included all participants who satisfied the eligibility criteria for the study. Here, 'N' (number of participants analyzed) included those participants who were evaluable for this measure.

6MWD was the distance that a participant could walk in 6 minutes. Participants were asked to perform the test at a pace that was comfortable to them, with as many breaks as they needed.

Outcome measures

Outcome measures
Measure
Sildenafil
n=132 Participants
Participants who received sildenafil greater than or equal to 20 milligram (mg) three times daily as per Summary of Product Characteristics (SmPC) for the treatment of pulmonary arterial hypertension (PAH) for a period of at least 3 months, were observed retrospectively for 5 years.
Change From Baseline in 6-Minute Walk Distance (6MWD) at Year 1
29.4 meter
Standard Deviation 81.38

PRIMARY outcome

Timeframe: Baseline, Year 2

Population: Analysis population included all participants who satisfied the eligibility criteria for the study. Here, 'N' (number of participants analyzed) included those participants who were evaluable for this measure.

6MWD was the distance that a participant could walk in 6 minutes. Participants were asked to perform the test at a pace that was comfortable to them, with as many breaks as they needed.

Outcome measures

Outcome measures
Measure
Sildenafil
n=74 Participants
Participants who received sildenafil greater than or equal to 20 milligram (mg) three times daily as per Summary of Product Characteristics (SmPC) for the treatment of pulmonary arterial hypertension (PAH) for a period of at least 3 months, were observed retrospectively for 5 years.
Change From Baseline in 6-Minute Walk Distance (6MWD) at Year 2
20.8 meter
Standard Deviation 83.82

PRIMARY outcome

Timeframe: Baseline, Year 3

Population: Analysis population included all participants who satisfied the eligibility criteria for the study. Here, 'N' (number of participants analyzed) included those participants who were evaluable for this measure.

6MWD was the distance that a participant could walk in 6 minutes. Participants were asked to perform the test at a pace that was comfortable to them, with as many breaks as they needed.

Outcome measures

Outcome measures
Measure
Sildenafil
n=31 Participants
Participants who received sildenafil greater than or equal to 20 milligram (mg) three times daily as per Summary of Product Characteristics (SmPC) for the treatment of pulmonary arterial hypertension (PAH) for a period of at least 3 months, were observed retrospectively for 5 years.
Change From Baseline in 6-Minute Walk Distance (6MWD) at Year 3
8.7 meter
Standard Deviation 73.82

PRIMARY outcome

Timeframe: Baseline, Year 4

Population: Analysis population included all participants who satisfied the eligibility criteria for the study. Here, 'N' (number of participants analyzed) included those participants who were evaluable for this measure.

6MWD was the distance that a participant could walk in 6 minutes. Participants were asked to perform the test at a pace that was comfortable to them, with as many breaks as they needed.

Outcome measures

Outcome measures
Measure
Sildenafil
n=9 Participants
Participants who received sildenafil greater than or equal to 20 milligram (mg) three times daily as per Summary of Product Characteristics (SmPC) for the treatment of pulmonary arterial hypertension (PAH) for a period of at least 3 months, were observed retrospectively for 5 years.
Change From Baseline in 6-Minute Walk Distance (6MWD) at Year 4
-50.2 meter
Standard Deviation 86.24

SECONDARY outcome

Timeframe: Baseline, Year 1, 2, 3, 4

Population: Analysis population included all participants who satisfied the eligibility criteria for the study. Here, 'N' (number of participants analyzed) included those participants who were evaluable for this measure. Here, 'n' included those participants who were evaluable for this measure at specified time points.

NYHA/WHO functional classification for PAH range from Class I (no limitation in physical activity, no dyspnea with normal activity) to Class IV (can not perform a physical activity without any symptoms, dyspnea at rest). Improvement=reduction in functional class, deterioration = increase in functional class, no change = no change in functional class. Number of participants in each functional class was reported.

Outcome measures

Outcome measures
Measure
Sildenafil
n=214 Participants
Participants who received sildenafil greater than or equal to 20 milligram (mg) three times daily as per Summary of Product Characteristics (SmPC) for the treatment of pulmonary arterial hypertension (PAH) for a period of at least 3 months, were observed retrospectively for 5 years.
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 1: Improved >1 class (n=214)
3 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 1: Improved 1 class (n=214)
36 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 1: No change (n=214)
140 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 1: Worsened 1 class (n=214)
12 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 1: Worsened >1 class (n=214)
5 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 2: Improved >1 class (n=156)
1 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 2: Improved 1 class (n=156)
27 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 2: No change (n=156)
100 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 2: Worsened 1 class (n=156)
7 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 2: Worsened >1 class (n=156)
4 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 3: Improved >1 class (n=88)
1 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 3: Improved 1 class (n=88)
12 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 3: No change (n=88)
57 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 3: Worsened 1 class (n=88)
7 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 3: Worsened >1 class (n=88)
0 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 4: Improved >1 class (n=45)
0 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 4: Improved 1 class (n=45)
6 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 4: No change (n=45)
27 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 4: Worsened 1 class (n=45)
2 participants
Change From Baseline in New York Heart Association, World Health Organization (NYHA/WHO) Functional Class in Participants With Pulmonary Arterial Hypertension (PAH) at Year 1, 2, 3 and 4
Year 4: Worsened >1 class (n=45)
0 participants

SECONDARY outcome

Timeframe: Baseline, Year 1, 2, 3, 4

Population: Data was not summarized because results were available for very few participants and were insufficient for analysis.

RAP was measured using a pressure transducer positioned at the mid-axillary line with the participant in the supine position.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline, Year 1, 2, 3, 4

Population: Data was not summarized because results were available for very few participants and were insufficient for analysis.

mPAP was measured using a pressure transducer positioned at the mid-axillary line with the participant in the supine position.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline, Year 1, 2, 3, 4

Population: Data was not summarized because results were available for very few participants and were insufficient for analysis.

PVR: calculated by subtracting PCWP from mPAP and dividing by cardiac output in pulmonary circulation (COpulm).

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline, Year 1, 2, 3, 4

Population: Data was not summarized because results were available for very few participants and were insufficient for analysis.

CI: calculated as COsys divided by BSA.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline, Year 1, 2, 3, 4

Population: Data was not summarized because results were available for very few participants and were insufficient for analysis.

PCWP was measured by pulmonary artery catheterization and provided an indirect measure of left atrial pressure.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline, Year 1, 2, 3, 4

Population: Analysis population included all participants who satisfied the eligibility criteria for the study. Here, 'N' (number of participants analyzed) included those participants who were evaluable for this measure. 'n' included those participants who were evaluable for this measure at specified time points.

Borg dyspnea scale: 10-point scale where following scores stands for severity of dyspnea: 0=no breathlessness at all;0.5=very very slight (just noticeable); 1=very slight; 2=slight breathlessness; 3=moderate; 4=some what severe; 5=severe; 7=very severe breathlessness; 9=very very severe (almost maximum) and 10=maximum.

Outcome measures

Outcome measures
Measure
Sildenafil
n=118 Participants
Participants who received sildenafil greater than or equal to 20 milligram (mg) three times daily as per Summary of Product Characteristics (SmPC) for the treatment of pulmonary arterial hypertension (PAH) for a period of at least 3 months, were observed retrospectively for 5 years.
Change From Baseline in Borg Dyspnea Index at Year 1, 2, 3 and 4
Change at Year 1 (n=118)
-0.4 units on a scale
Standard Deviation 1.88
Change From Baseline in Borg Dyspnea Index at Year 1, 2, 3 and 4
Change at Year 2 (n=65)
0.0 units on a scale
Standard Deviation 2.01
Change From Baseline in Borg Dyspnea Index at Year 1, 2, 3 and 4
Change at Year 3 (n=27)
0.3 units on a scale
Standard Deviation 1.82
Change From Baseline in Borg Dyspnea Index at Year 1, 2, 3 and 4
Change at Year 4 (n=8)
0.4 units on a scale
Standard Deviation 1.92

Adverse Events

Sildenafil

Serious events: 0 serious events
Other events: 11 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Sildenafil
n=227 participants at risk
Participants who received sildenafil greater than or equal to 20 milligram (mg) three times daily as per Summary of Product Characteristics (SmPC) for the treatment of pulmonary arterial hypertension (PAH) for a period of at least 3 months, were observed retrospectively for 5 years.
General disorders
Ankle oedema, facial flushing
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Back pain or dizziness or eyesight
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Cough
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Dizziness
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Gastro-intestinal symptoms
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Head fuzzy/mild headache/mild flushing/mild nasal congestion
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Headache, diarrhoea and anxiety
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Mild headache/increased heart rate
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Nasal stuffiness/headache
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Nose bleeds
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Rash/itch (severe)
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Red face/peripheral oedema
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Vague upper abdominal discomfort by suspected pancreatic cancer
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.
General disorders
Worsening of PAH
0.44%
1/227
Only those adverse events that were determined to be related to sildenafil by the investigator were reported in this observational retrospective study.

Additional Information

Pfizer ClinicalTrials.gov Call Center

Pfizer, Inc.

Phone: 1-800-718-1021

Results disclosure agreements

  • Principal investigator is a sponsor employee Pfizer has the right to review disclosures, requesting a delay of less than 60 days. Investigator will postpone single center publications until after disclosure of pooled data (all sites), less than 12 months from study completion/termination at all participating sites. Investigator may not disclose previously undisclosed confidential information other than study results.
  • Publication restrictions are in place

Restriction type: OTHER