Trial Outcomes & Findings for Persistent Pulmonary Hypertension of the Newborn (NCT NCT01389856)

NCT ID: NCT01389856

Last Updated: 2025-02-04

Results Overview

Treatment failure was defined as the need for extra corporeal membrane oxygenation or initiation of alternative pulmonary vasodilator treatment

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

23 participants

Primary outcome timeframe

From baseline to up to 21 days

Results posted on

2025-02-04

Participant Flow

First patient, first visit was 8 December 2011 and last patient, last visit was 5 December 2013. The investigational sites were tertiary care centers with neonatal intensive care unit facilities at which inhaled nitric oxide (iNO) was used as standard of care for persistent pulmonary hypertension of the newborn (PPHN).

Term or near-term (gestational age \> 34 weeks) hypoxic newborns with respiratory distress refractory to supplemental oxygen were considered, provided they had no significant structural cardiac anomalies documented in the pre-natal period and had no immediate need for extra corporeal membrane oxygenation (ECMO).

Participant milestones

Participant milestones
Measure
Bosentan
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Overall Study
STARTED
13
8
Overall Study
COMPLETED
13
8
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Persistent Pulmonary Hypertension of the Newborn

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Bosentan
n=13 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Total
n=21 Participants
Total of all reporting groups
Age, Continuous
1.4 days
n=5 Participants
1.7 days
n=7 Participants
1.4 days
n=5 Participants
Sex: Female, Male
Female
9 Participants
n=5 Participants
6 Participants
n=7 Participants
15 Participants
n=5 Participants
Sex: Female, Male
Male
4 Participants
n=5 Participants
2 Participants
n=7 Participants
6 Participants
n=5 Participants
Race/Ethnicity, Customized
Caucasian/white
11 participants
n=5 Participants
6 participants
n=7 Participants
17 participants
n=5 Participants
Race/Ethnicity, Customized
Asian
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic
1 participants
n=5 Participants
1 participants
n=7 Participants
2 participants
n=5 Participants
Race/Ethnicity, Customized
Other
0 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
Region of Enrollment
Czech Republic
1 participants
n=5 Participants
1 participants
n=7 Participants
2 participants
n=5 Participants
Region of Enrollment
France
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Region of Enrollment
Korea, Republic of
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Region of Enrollment
Poland
5 participants
n=5 Participants
3 participants
n=7 Participants
8 participants
n=5 Participants
Region of Enrollment
United Kingdom
4 participants
n=5 Participants
2 participants
n=7 Participants
6 participants
n=5 Participants
Region of Enrollment
United States
1 participants
n=5 Participants
2 participants
n=7 Participants
3 participants
n=5 Participants
Gestational age
40.0 weeks
n=5 Participants
38.5 weeks
n=7 Participants
39.0 weeks
n=5 Participants

PRIMARY outcome

Timeframe: From baseline to up to 21 days

Population: Randomized and treated patients

Treatment failure was defined as the need for extra corporeal membrane oxygenation or initiation of alternative pulmonary vasodilator treatment

Outcome measures

Outcome measures
Measure
Bosentan
n=13 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Percentage of Patients With Treatment Failure
7.7 percentage of participants
0 percentage of participants

PRIMARY outcome

Timeframe: From baseline to up to 21 days

Population: Randomized and treated patients

Calculated from the time from first study drug administration to complete weaning from iNO. Weaning from iNO was considered complete if there was no requirement for the re-initiation of iNO within 24 h after stopping

Outcome measures

Outcome measures
Measure
Bosentan
n=13 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Time to Complete Weaning From iNO
3.7 days
Interval 1.17 to 6.95
2.9 days
Interval 1.26 to 4.23

PRIMARY outcome

Timeframe: From baseline to up to 21 days

Population: Randomized and treated patients

Calculated from the time from first study drug administration to complete weaning from mechanical ventilation

Outcome measures

Outcome measures
Measure
Bosentan
n=13 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Time to Complete Weaning From Mechanical Ventilation
10.8 days
Interval 3.21 to 12.21
8.6 days
Interval 3.71 to 9.66

SECONDARY outcome

Timeframe: From baseline to up to 21 days

Population: Randomized and treated patients

Re-initiation of iNO therapy following weaning from iNO therapy

Outcome measures

Outcome measures
Measure
Bosentan
n=13 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Percentage of Patients Requiring Re-initiation of iNO Therapy
0 percentage of participants
0 percentage of participants

SECONDARY outcome

Timeframe: From baseline to up to 14 days

Population: Randomized and treated patients

The presence of PH was assessed by echocardiography. PH was reported as 'present' if at least one of the following criteria was met: * Shunt through ductus arteriosus was either 'predominant right to left' or 'bidirectional' * Shunt through foramen ovale was either 'predominant right to left' or 'bidirectional' * Marked right ventricular dilation was ticked 'present' * Paradoxical shift of intraventricular septum was ticked 'present' * Right ventricular systolic pressure (mmHg) was \> 2/3 of the reported systemic blood pressure

Outcome measures

Outcome measures
Measure
Bosentan
n=13 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Percentage of Patients With Pulmonary Hypertension (PH) at End of Treatment
41.7 percentage of participants
37.5 percentage of participants

SECONDARY outcome

Timeframe: 3 hours

Population: Randomized and treated patients

The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood.

Outcome measures

Outcome measures
Measure
Bosentan
n=13 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Oxygenation Index (OI) From Baseline to 3 Hours Following Study Drug Administration
Baseline
18.3 oxygenation index
Interval 8.2 to 35.4
13.2 oxygenation index
Interval 7.9 to 39.4
Change in Oxygenation Index (OI) From Baseline to 3 Hours Following Study Drug Administration
3 hours
17.3 oxygenation index
Interval 6.9 to 33.3
13.0 oxygenation index
Interval 8.5 to 42.9
Change in Oxygenation Index (OI) From Baseline to 3 Hours Following Study Drug Administration
Change from baseline
-1.6 oxygenation index
Interval -5.1 to 3.3
1.1 oxygenation index
Interval -6.1 to 6.1

SECONDARY outcome

Timeframe: 5 hours

Population: Randomized and treated patients

The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood.

Outcome measures

Outcome measures
Measure
Bosentan
n=13 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Oxygenation Index (OI) From Baseline to 5 Hours Following Study Drug Administration
Baseline
18.3 oxygenation index
Interval 8.2 to 35.4
13.2 oxygenation index
Interval 7.9 to 39.4
Change in Oxygenation Index (OI) From Baseline to 5 Hours Following Study Drug Administration
5 hours
16.7 oxygenation index
Interval 7.9 to 36.7
13.3 oxygenation index
Interval 6.7 to 28.6
Change in Oxygenation Index (OI) From Baseline to 5 Hours Following Study Drug Administration
Change from baseline
-0.9 oxygenation index
Interval -4.7 to 4.5
-5.6 oxygenation index
Interval -7.5 to 15.7

SECONDARY outcome

Timeframe: 12 hours

Population: Randomized and treated patients

The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood.

Outcome measures

Outcome measures
Measure
Bosentan
n=13 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Oxygenation Index (OI) From Baseline to 12 Hours Following Study Drug Administration
Baseline
18.3 oxygenation index
Interval 8.2 to 35.4
13.2 oxygenation index
Interval 7.9 to 39.4
Change in Oxygenation Index (OI) From Baseline to 12 Hours Following Study Drug Administration
12 hours
14.3 oxygenation index
Interval 8.3 to 26.7
11.1 oxygenation index
Interval 4.9 to 19.6
Change in Oxygenation Index (OI) From Baseline to 12 Hours Following Study Drug Administration
Change from baseline
-0.8 oxygenation index
Interval -12.9 to 2.8
-3.9 oxygenation index
Interval -14.6 to 12.5

SECONDARY outcome

Timeframe: 24 hours

Population: Randomized and treated patients

The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood.

Outcome measures

Outcome measures
Measure
Bosentan
n=13 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Oxygenation Index (OI) From Baseline to 24 Hours Following Study Drug Administration
Baseline
18.3 oxygenation index
Interval 8.2 to 35.4
13.2 oxygenation index
Interval 7.9 to 39.4
Change in Oxygenation Index (OI) From Baseline to 24 Hours Following Study Drug Administration
24 hours
13.1 oxygenation index
Interval 6.5 to 32.9
11.8 oxygenation index
Interval 5.2 to 26.4
Change in Oxygenation Index (OI) From Baseline to 24 Hours Following Study Drug Administration
Change from baseline
-4.9 oxygenation index
Interval -17.0 to 1.1
-6.9 oxygenation index
Interval -9.9 to 19.4

SECONDARY outcome

Timeframe: 48 hours

Population: Randomized and treated patients with available data

The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood.

Outcome measures

Outcome measures
Measure
Bosentan
n=12 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Oxygenation Index (OI) From Baseline to 48 Hours Following Study Drug Administration
Baseline
19.4 oxygenation index
Interval 8.2 to 35.4
13.2 oxygenation index
Interval 7.9 to 39.4
Change in Oxygenation Index (OI) From Baseline to 48 Hours Following Study Drug Administration
48 hours
11.5 oxygenation index
Interval 4.7 to 21.0
3.8 oxygenation index
Interval 2.5 to 10.8
Change in Oxygenation Index (OI) From Baseline to 48 Hours Following Study Drug Administration
Change from baseline
-4.9 oxygenation index
Interval -15.5 to -2.1
-9.9 oxygenation index
Interval -18.0 to 3.4

SECONDARY outcome

Timeframe: 72 hours

Population: Randomized and treated patients with available data

The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood.

Outcome measures

Outcome measures
Measure
Bosentan
n=12 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Oxygenation Index (OI) From Baseline to 72 Hours Following Study Drug Administration
Baseline
19.4 oxygenation index
Interval 8.2 to 35.4
13.2 oxygenation index
Interval 7.9 to 39.4
Change in Oxygenation Index (OI) From Baseline to 72 Hours Following Study Drug Administration
72 hours
6.7 oxygenation index
Interval 4.2 to 17.0
3.9 oxygenation index
Interval 3.7 to 10.8
Change in Oxygenation Index (OI) From Baseline to 72 Hours Following Study Drug Administration
Change from baseline
-8.9 oxygenation index
Interval -23.1 to -1.8
-9.4 oxygenation index
Interval -17.7 to 2.2

SECONDARY outcome

Timeframe: 72 hours

Population: Randomized and treated patients with available data

pH was determined in arterial blood samples at baseline and 72 h after the first study drug administration

Outcome measures

Outcome measures
Measure
Bosentan
n=12 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Arterial Blood Gas (ABG) pH From Baseline to 72 Hours Following Study Drug Administration
Baseline
7.37 pH
Interval 7.3 to 7.43
7.31 pH
Interval 7.21 to 7.49
Change in Arterial Blood Gas (ABG) pH From Baseline to 72 Hours Following Study Drug Administration
72 hours
7.37 pH
Interval 7.36 to 7.43
7.36 pH
Interval 7.3 to 7.39
Change in Arterial Blood Gas (ABG) pH From Baseline to 72 Hours Following Study Drug Administration
Change from baseline
0.04 pH
Interval -0.06 to 0.07
0.02 pH
Interval -0.09 to 0.19

SECONDARY outcome

Timeframe: 72 hours

Population: Randomized and treated patients with available data

SaO2 was determined in arterial blood samples at baseline and 72 h after the first study drug administration

Outcome measures

Outcome measures
Measure
Bosentan
n=11 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Arterial Blood Oxygen Saturation (SaO2) From Baseline to 72 Hours Following Study Drug Administration
Baseline
95.0 percentage saturation
Interval 92.0 to 99.0
95.5 percentage saturation
Interval 89.0 to 99.0
Change in Arterial Blood Oxygen Saturation (SaO2) From Baseline to 72 Hours Following Study Drug Administration
72 hours
98.0 percentage saturation
Interval 95.0 to 100.0
97.0 percentage saturation
Interval 93.0 to 100.0
Change in Arterial Blood Oxygen Saturation (SaO2) From Baseline to 72 Hours Following Study Drug Administration
Change from baseline
1.0 percentage saturation
Interval 0.0 to 8.0
0.0 percentage saturation
Interval -4.0 to 21.0

SECONDARY outcome

Timeframe: 72 hours

Population: Randomized and treated patients with available data

PaO2 was determined in arterial blood samples at baseline and 72 h after the first study drug administration

Outcome measures

Outcome measures
Measure
Bosentan
n=12 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Partial Pressure of Oxygen (PaO2) in Arterial Blood From Baseline to 72 Hours Following Study Drug Administration
Baseline
61.0 mm Hg
Interval 53.0 to 132.0
69.5 mm Hg
Interval 46.0 to 111.0
Change in Partial Pressure of Oxygen (PaO2) in Arterial Blood From Baseline to 72 Hours Following Study Drug Administration
72 hours
81.0 mm Hg
Interval 61.0 to 104.0
81.5 mm Hg
Interval 56.0 to 187.0
Change in Partial Pressure of Oxygen (PaO2) in Arterial Blood From Baseline to 72 Hours Following Study Drug Administration
Change from baseline
18.0 mm Hg
Interval -13.0 to 32.0
6.0 mm Hg
Interval -12.0 to 115.0

SECONDARY outcome

Timeframe: 72 hours

Population: Randomized and treated patients with available data

PaCO2 was determined in arterial blood samples at baseline and 72 h after the first study drug administration

Outcome measures

Outcome measures
Measure
Bosentan
n=12 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Partial Pressure of Carbon Dioxide (PaCO2) in Arterial Blood From Baseline to 72 Hours Following Study Drug Administration
Baseline
40.5 mm Hg
Interval 31.0 to 47.0
46.0 mm Hg
Interval 35.0 to 57.0
Change in Partial Pressure of Carbon Dioxide (PaCO2) in Arterial Blood From Baseline to 72 Hours Following Study Drug Administration
72 hours
45.5 mm Hg
Interval 36.0 to 49.0
46.0 mm Hg
Interval 41.0 to 64.0
Change in Partial Pressure of Carbon Dioxide (PaCO2) in Arterial Blood From Baseline to 72 Hours Following Study Drug Administration
Change from baseline
6.0 mm Hg
Interval -1.0 to 12.0
8.0 mm Hg
Interval -8.0 to 21.0

SECONDARY outcome

Timeframe: 72 hours

Population: Randomized and treated patients with available data

Simultaneous pre- (right hand) and post-ductal (lower extremities) SpO2 were measured using pulse oximetry device at baseline and 72 h after the first study drug administration

Outcome measures

Outcome measures
Measure
Bosentan
n=12 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=7 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Pre-ductal Peripheral Oxygen Saturation (SpO2) From Baseline to 72 Hours Following Study Drug Administration
72 hours
96.00 percentage saturation
Interval 93.0 to 100.0
96.00 percentage saturation
Interval 85.0 to 100.0
Change in Pre-ductal Peripheral Oxygen Saturation (SpO2) From Baseline to 72 Hours Following Study Drug Administration
Baseline
95.00 percentage saturation
Interval 91.0 to 99.0
97.00 percentage saturation
Interval 91.0 to 99.0
Change in Pre-ductal Peripheral Oxygen Saturation (SpO2) From Baseline to 72 Hours Following Study Drug Administration
Change from baseline
0.50 percentage saturation
Interval -2.0 to 2.0
-1.00 percentage saturation
Interval -10.0 to 2.0

SECONDARY outcome

Timeframe: 72 hours

Population: Randomized and treated patients with available data

Simultaneous pre- (right hand) and post-ductal (lower extremities) SpO2 were measured using pulse oximetry device at baseline and 72 h after the first study drug administration

Outcome measures

Outcome measures
Measure
Bosentan
n=12 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Post-ductal Peripheral Oxygen Saturation (SpO2) From Baseline to 72 Hours Following Study Drug Administration
Baseline
96.5 percentage saturation
Interval 92.0 to 99.0
96.0 percentage saturation
Interval 89.0 to 98.0
Change in Post-ductal Peripheral Oxygen Saturation (SpO2) From Baseline to 72 Hours Following Study Drug Administration
72 hours
95.5 percentage saturation
Interval 94.0 to 99.0
97.5 percentage saturation
Interval 95.0 to 100.0
Change in Post-ductal Peripheral Oxygen Saturation (SpO2) From Baseline to 72 Hours Following Study Drug Administration
Change from baseline
0.0 percentage saturation
Interval -2.0 to 3.0
2.0 percentage saturation
Interval 1.0 to 12.0

SECONDARY outcome

Timeframe: 72 hours

Population: Randomized and treated patients with available data

FiO2 was determined according to each study centers' standard procedure at baseline and 72 h after the first study drug administration

Outcome measures

Outcome measures
Measure
Bosentan
n=12 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 Participants
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Change in Fraction of Inspired Oxygen (FiO2) From Baseline to 72 Hours Following Study Drug Administration
Baseline
90.0 percentage of oxygen
Interval 62.0 to 97.0
78.0 percentage of oxygen
Interval 60.0 to 100.0
Change in Fraction of Inspired Oxygen (FiO2) From Baseline to 72 Hours Following Study Drug Administration
72 hours
51.5 percentage of oxygen
Interval 28.0 to 60.0
40.0 percentage of oxygen
Interval 25.0 to 60.0
Change in Fraction of Inspired Oxygen (FiO2) From Baseline to 72 Hours Following Study Drug Administration
Change from baseline
-33.5 percentage of oxygen
Interval -50.0 to -15.0
-35.5 percentage of oxygen
Interval -60.0 to 0.0

SECONDARY outcome

Timeframe: up to 12 hours

Population: Pharmacokinetic (PK) analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Cmax was obtained directly from the measured concentrations. Cmax was corrected to a dose of 2 mg/kg bosentan (Cmaxc). The target dose was 2 mg/kg. However, as the smallest dose unit was 8 mg (quarter of a tablet), it was not possible to achieve the exact target dose in all patients. Therefore, Cmax was divided by the actual dose (in mg/kg) and multiplied by 2 mg/kg.

Outcome measures

Outcome measures
Measure
Bosentan
n=11 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Maximum Whole Blood Concentration (Cmax) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1
Bosentan
30.1 ng/mL
Interval 2.4 to 372.2
Maximum Whole Blood Concentration (Cmax) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1
Ro 47-8634
0.1 ng/mL
Interval 0.0 to 1.1
Maximum Whole Blood Concentration (Cmax) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1
Ro 48-5033
0.6 ng/mL
Interval 0.0 to 18.3
Maximum Whole Blood Concentration (Cmax) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1
Ro 64-1056
0.9 ng/mL
Interval 0.0 to 16.2

SECONDARY outcome

Timeframe: 12 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Cmax obtained directly from the measured concentrations . Cmax was corrected to a dose of 2 mg/kg bosentan (Cmaxc). The target dose was 2 mg/kg. However, as the smallest dose unit was 8 mg (quarter of a tablet), it was not possible to achieve the exact target dose in all patients. Therefore, Cmax was divided by the actual dose (in mg/kg) and multiplied by 2 mg/kg.

Outcome measures

Outcome measures
Measure
Bosentan
n=7 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Cmax for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 5
Bosentan
880.0 ng/mL
Interval 339.2 to 2282.7
Cmax for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 5
Ro 47-8634
24.9 ng/mL
Interval 9.0 to 69.1
Cmax for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 5
Ro 48-5033
292.3 ng/mL
Interval 115.8 to 738.1
Cmax for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 5
Ro 64-1056
136.0 ng/mL
Interval 77.4 to 238.8

SECONDARY outcome

Timeframe: up to 12 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations.

Outcome measures

Outcome measures
Measure
Bosentan
n=10 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Time to Maximum Whole Blood Concentration (Tmax) for Bosentan on Day 1
12.0 hours
Interval 7.5 to 12.0

SECONDARY outcome

Timeframe: up to 12 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations.

Outcome measures

Outcome measures
Measure
Bosentan
n=5 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Tmax for Ro 47-8634 on Day 1
12.0 hours
Interval 7.5 to 12.0

SECONDARY outcome

Timeframe: up to 12 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations.

Outcome measures

Outcome measures
Measure
Bosentan
n=7 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Tmax for Ro 48-5033 on Day 1
12.0 hours
Interval 12.0 to 12.0

SECONDARY outcome

Timeframe: up to 12 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations.

Outcome measures

Outcome measures
Measure
Bosentan
n=8 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Tmax for Ro 64-1056 on Day 1
12 hours
Interval 0.5 to 12.0

SECONDARY outcome

Timeframe: 12 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations.

Outcome measures

Outcome measures
Measure
Bosentan
n=7 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Tmax for Bosentan on Day 5
7.5 hours
Interval 0.8 to 12.0

SECONDARY outcome

Timeframe: 12 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations.

Outcome measures

Outcome measures
Measure
Bosentan
n=7 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Tmax for Ro 47-8634 on Day 5
6.5 hours
Interval 0.8 to 12.0

SECONDARY outcome

Timeframe: 12 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations.

Outcome measures

Outcome measures
Measure
Bosentan
n=7 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Tmax for Ro 48-5033 on Day 5
7.5 hours
Interval 0.8 to 12.0

SECONDARY outcome

Timeframe: 12 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations.

Outcome measures

Outcome measures
Measure
Bosentan
n=7 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Tmax for Ro 64-1056 on Day 5
12.0 hours
Interval 7.5 to 12.0

SECONDARY outcome

Timeframe: 12 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUC0-12 Day 1 was calculated according to the trapezoidal rule using the measured concentration-time values above the limit of quantification.

Outcome measures

Outcome measures
Measure
Bosentan
n=11 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Area Under the Concentration-time Curve Over a Period of 12 h (AUC0-12 Day 1)) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1
Bosentan
163.9 h*ng/mL
Interval 9.6 to 2795.4
Area Under the Concentration-time Curve Over a Period of 12 h (AUC0-12 Day 1)) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1
Ro 47-8634
0.1 h*ng/mL
Interval 0.0 to 3.7
Area Under the Concentration-time Curve Over a Period of 12 h (AUC0-12 Day 1)) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1
Ro 48-5033
1.4 h*ng/mL
Interval 0.0 to 69.9
Area Under the Concentration-time Curve Over a Period of 12 h (AUC0-12 Day 1)) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1
Ro 64-1056
2.2 h*ng/mL
Interval 0.1 to 64.1

SECONDARY outcome

Timeframe: 5 days

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUCtau Day 5 was calculated according to the trapezoidal rule using the measured concentration-time values above the limit of quantification.

Outcome measures

Outcome measures
Measure
Bosentan
n=7 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Area Under the Concentration-time Curve Over a Dosing Interval at Steady State on Day 5 (AUCtau) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Bosentan
6165.4 h*ng/mL
Interval 2429.6 to 15645.3
Area Under the Concentration-time Curve Over a Dosing Interval at Steady State on Day 5 (AUCtau) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Ro 48-5033
2839.5 h*ng/mL
Interval 1155.2 to 6979.2
Area Under the Concentration-time Curve Over a Dosing Interval at Steady State on Day 5 (AUCtau) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Ro 64-1056
1321.7 h*ng/mL
Interval 729.5 to 2395.0
Area Under the Concentration-time Curve Over a Dosing Interval at Steady State on Day 5 (AUCtau) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Ro 47-8634
217.3 h*ng/mL
Interval 75.3 to 626.8

SECONDARY outcome

Timeframe: 24 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUC0-24C Day 1 was calculated as a multiple of AUC0-12, (2 × AUC0-12 for 2 times daily dosing) corrected to 2 mg/kg.

Outcome measures

Outcome measures
Measure
Bosentan
n=11 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 1 (AUC0-24C Day 1) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Bosentan
287.5 h*ng/mL
Interval 15.0 to 5504.7
Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 1 (AUC0-24C Day 1) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Ro 47-8634
0.1 h*ng/mL
Interval 0.0 to 6.1
Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 1 (AUC0-24C Day 1) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Ro 48-5033
2.0 h*ng/mL
Interval 0.0 to 125.8
Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 1 (AUC0-24C Day 1) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Ro 64-1056
3.4 h*ng/mL
Interval 0.1 to 120.8

SECONDARY outcome

Timeframe: 24 hours

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUC0-24C Day 5 was calculated as a multiple of AUCtau, (2 × AUCtau for 2 times daily dosing) corrected to 2 mg/kg.

Outcome measures

Outcome measures
Measure
Bosentan
n=7 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 5 (AUC0-24C Day 5) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Bosentan
11530.2 h*ng/mL
Interval 4507.0 to 29497.5
Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 5 (AUC0-24C Day 5) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Ro 47-8634
406.3 h*ng/mL
Interval 139.8 to 1180.9
Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 5 (AUC0-24C Day 5) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Ro 48-5033
5310.3 h*ng/mL
Interval 2184.4 to 12908.9
Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 5 (AUC0-24C Day 5) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056
Ro 64-1056
2471.9 h*ng/mL
Interval 1386.1 to 4408.0

SECONDARY outcome

Timeframe: 5 days

Population: PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints.

Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Days 1 and 5. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AI was calculated as the ratio AUCtau /AUC0-12 for the subjects having PK samples collected on Day 1 and Day 5 and with AUC0-12 \> 0 ng.h/mL.

Outcome measures

Outcome measures
Measure
Bosentan
n=7 Participants
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Accumulation Index (AI) for Bosentan
61.6 accumulation index
Interval 0.5 to 7813.9

Adverse Events

Bosentan

Serious events: 2 serious events
Other events: 9 other events
Deaths: 0 deaths

Placebo

Serious events: 3 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Bosentan
n=13 participants at risk
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 participants at risk
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Hepatobiliary disorders
HEPATITIS
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Metabolism and nutrition disorders
METABOLIC ACIDOSIS
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Respiratory, thoracic and mediastinal disorders
HYPERCAPNIA
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Respiratory, thoracic and mediastinal disorders
PNEUMOTHORAX
0.00%
0/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
25.0%
2/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Vascular disorders
CIRCULATORY COLLAPSE
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Infections and infestations
SEPSIS
0.00%
0/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
12.5%
1/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events

Other adverse events

Other adverse events
Measure
Bosentan
n=13 participants at risk
Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube.
Placebo
n=8 participants at risk
Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
Blood and lymphatic system disorders
ANAEMIA
23.1%
3/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
12.5%
1/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
General disorders
GENERALISED OEDEMA
23.1%
3/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Blood and lymphatic system disorders
COAGULOPATHY
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
12.5%
1/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Gastrointestinal disorders
VOMITING
15.4%
2/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Investigations
BILIRUBIN CONJUGATED INCREASED
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Investigations
BODY TEMPERATURE INCREASED
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Investigations
C-REACTIVE PROTEIN INCREASED
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Respiratory, thoracic and mediastinal disorders
DYSPHONIA
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Injury, poisoning and procedural complications
ENDOTRACHEAL INTUBATION COMPLICATION
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Gastrointestinal disorders
GASTRIC HAEMORRHAGE
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Metabolism and nutrition disorders
HYPOGLYCAEMIA
0.00%
0/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
12.5%
1/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Metabolism and nutrition disorders
HYPOKALAEMIA
0.00%
0/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
12.5%
1/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Metabolism and nutrition disorders
HYPOPHOSPHATAEMIA
0.00%
0/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
12.5%
1/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Infections and infestations
INFECTIOUS DISEASE CARRIER
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Metabolism and nutrition disorders
METABOLIC ACIDOSIS
0.00%
0/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
12.5%
1/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Blood and lymphatic system disorders
METHAEMOGLOBINAEMIA
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Cardiac disorders
MITRAL VALVE INCOMPETENCE
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Respiratory, thoracic and mediastinal disorders
PNEUMOMEDIASTINUM
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Respiratory, thoracic and mediastinal disorders
PNEUMOTHORAX
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Injury, poisoning and procedural complications
PROCEDURAL COMPLICATION
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
Blood and lymphatic system disorders
THROMBOCYTOPENIA
7.7%
1/13 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
0.00%
0/8 • Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events

Additional Information

Pegah Nowbakht/Senior Clinical Trial Scientist

Actelion Pharmaceuticals Ltd

Phone: +41 61 565 68 41

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: OTHER