Two-Part Dose-Confirming Study of Pulsed Inhaled Nitric Oxide in Subjects With WHO Group 3 Pulmonary Hypertension Associated With COPD

NCT ID: NCT01728220

Last Updated: 2023-02-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

159 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-12-31

Study Completion Date

2014-07-31

Brief Summary

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This is a placebo-controlled, double-blind, parallel, randomized, two-part, dose-confirming clinical study characterizing the pharmacodynamic effects of pulsed iNO using the combination product, inhaled nitric oxide/INOpulse DS-C vs. placebo in subjects with World Health Organization (WHO) Group 3 pulmonary hypertension (PH) associated with Chronic Obstructive Pulmonary Disease (COPD) on Long Term Oxygen Therapy (LTOT).

Detailed Description

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This two-part study is designed to confirm the dose of inhaled nitric oxide (NO), administered through an investigational pulsed delivery device (INOpulse® DS-C) that results in decreased pulmonary arterial systolic pressure (PASP) without significantly affecting systemic oxygenation.

In Part A, 80 subjects will be randomized to 1of 4 treatment groups in a 1:1:1:1 ratio (with 20 subjects in each treatment group). Subjects assigned to an iNO group will receive pulsed iNO at a dose of 0.003 mg/kg IBW/hr, 0.010 mg/kg IBW/hr, or 0.015 mg/kg IBW/hr, with a set pulse width (PW) of 260 milliseconds (ms). Part A subjects assigned to the placebo group will receive nitrogen (N2) at a randomly assigned device setting of 0.003, 0.010 or 0.015 mg/kg IBW/hr with a set PW of 260 ms.

Subjects who were randomized in Part A are permitted to participate in Part B of the study. Subjects will need to be re-screened and re-randomized for Part B participation.

In Part B, 60 subjects will be randomized to 1 of 3 treatment groups in a 1:1:1 ratio (with 20 subjects in each treatment group). Subjects assigned to an iNO group will receive pulsed iNO at either 0.030 mg/kg IBW/hr or 0.075 mg/kg IBW/hr, with a set PW of 260 ms. Part B subjects assigned to placebo will receive N2 at a randomly assigned device setting of 0.030 mg/kg IBW/hr or 0.075 mg/kg IBW/hr with a set PW of 260 ms.

Part B will use a skewed block randomization scheme with 10 blocks of 6 subjects as follows:

* Blocks 1-3: 3 subjects at 0.030 mg/kg IBW/hr, 1 subject at 0.075 mg/kg IBW/hr, and 2 subjects randomly assigned to placebo either 0.030 or 0.075 mg/kg IBW/hr
* Blocks 4-7: 2 subjects at 0.030 mg/kg IBW/hr, 2 subjects at 0.075 mg/kg IBW/hr, and 2 subjects randomly assigned to placebo either 0.030 or 0.075 mg/kg IBW/hr
* Blocks 8-10: 1 subject at 0.030 mg/kg IBW/hr, 3 subjects at 0.075 mg/kg IBW/hr, and 2 subjects randomly assigned to placebo either 0.030 or 0.075 mg/kg IBW/hr

Conditions

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Pulmonary Hypertension Chronic Obstructive Pulmonary Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Inhaled NO @ 0.003 mg/kg/ ideal body weight (IBW)/hr (Part A)

Inhaled NO using 3.0 mg/L \[2440 ppm\] NO minicylinder delivered via INOpulse® DS-C device

Group Type ACTIVE_COMPARATOR

Inhaled NO delivered via INOpulse DS-C Device

Intervention Type COMBINATION_PRODUCT

Subjects will be treated with nitric oxide by means of an INOpulse DS-C device using an INOpulse nasal cannula.

Inhaled NO @ 0.010 mg/kg/IBW/hr (Part A)

Inhaled NO using 3.0 mg/L \[2440 ppm\] NO minicylinder delivered via INOpulse® DS-C device

Group Type ACTIVE_COMPARATOR

Inhaled NO delivered via INOpulse DS-C Device

Intervention Type COMBINATION_PRODUCT

Subjects will be treated with nitric oxide by means of an INOpulse DS-C device using an INOpulse nasal cannula.

Inhaled NO @ 0.015 mg/kg/IBW/hr (Part A)

Inhaled NO using 6.0 mg/L \[4880 ppm\] NO minicylinder delivered via INOpulse® DS-C device

Group Type ACTIVE_COMPARATOR

Inhaled NO delivered via INOpulse DS-C Device

Intervention Type COMBINATION_PRODUCT

Subjects will be treated with nitric oxide by means of an INOpulse DS-C device using an INOpulse nasal cannula.

Placebo random @ 0.003, 0.010 or 0.015 mg/kg/IBW/hr (Part A)

Placebo using 99.999% N2 minicylinder delivered via INOpulse® DS-C device

Group Type PLACEBO_COMPARATOR

Placebo delivered via INOpulse DS-C Device

Intervention Type COMBINATION_PRODUCT

Subjects will be treated with nitrogen gas by means of an INOpulse DS-C device using an INOpulse nasal cannula.

Inhaled NO @ 0.030 mg/kg IBW/hr (Part B)

Inhaled NO using 6.0 mg/L \[4880 ppm\] NO minicylinder delivered via INOpulse® DS-C device

Group Type ACTIVE_COMPARATOR

Inhaled NO delivered via INOpulse DS-C Device

Intervention Type COMBINATION_PRODUCT

Subjects will be treated with nitric oxide by means of an INOpulse DS-C device using an INOpulse nasal cannula.

Inhaled NO @ 0.075 mg/kg IBW/hr (Part B)

Inhaled NO using 6.0 mg/L \[4880 ppm\] NO minicylinder delivered via INOpulse® DS-C device

Group Type ACTIVE_COMPARATOR

Inhaled NO delivered via INOpulse DS-C Device

Intervention Type COMBINATION_PRODUCT

Subjects will be treated with nitric oxide by means of an INOpulse DS-C device using an INOpulse nasal cannula.

Placebo random @ 0.030 or 0.075 mg/kg/IBW (Part B)

Placebo using 99.999% N2 minicylinder delivered via INOpulse® DS-C device

Group Type ACTIVE_COMPARATOR

Placebo delivered via INOpulse DS-C Device

Intervention Type COMBINATION_PRODUCT

Subjects will be treated with nitrogen gas by means of an INOpulse DS-C device using an INOpulse nasal cannula.

Interventions

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Inhaled NO delivered via INOpulse DS-C Device

Subjects will be treated with nitric oxide by means of an INOpulse DS-C device using an INOpulse nasal cannula.

Intervention Type COMBINATION_PRODUCT

Placebo delivered via INOpulse DS-C Device

Subjects will be treated with nitrogen gas by means of an INOpulse DS-C device using an INOpulse nasal cannula.

Intervention Type COMBINATION_PRODUCT

Eligibility Criteria

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Inclusion Criteria

1. Former smokers with at least 10 pack-years of tobacco cigarette smoking history before study entry and who have stopped smoking ≥ 1 month prior to enrollment
2. Age ≥ 40 years, ≤ 80 years
3. A confirmed diagnosis of COPD by the Global initiative for chronic Obstructive Lung Disease (GOLD) criteria
4. A post-bronchodilatory forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) \< 0.7 and a FEV1 \< 60% predicted (values obtained within 6 months prior to screening can be used unless obtained within ± 7 days of an exacerbation; otherwise, the test must be performed during screening)
5. Receiving LTOT for ≥ 3 months and ≥ 10 hours per day as determined by history
6. Echocardiogram with technical adequacy demonstrating tricuspid regurgitation velocity (TRV) ≥ 2.9 m/s at Screening, as determined by a blinded central echocardiography laboratory
7. Females of childbearing potential must have a negative pre-treatment urine pregnancy test
8. Signed informed consent prior to the initiation of any study mandated procedures or assessments

Exclusion Criteria

Subjects who meet any of the following criteria are not eligible for enrollment:

1. Positive urine cotinine test
2. Currently using, or having used within the past month, a nicotine patch
3. A diagnosis of asthma or other non-COPD respiratory disease, in the opinion of the Investigator
4. Lack of patency of nares upon physical examination
5. Experienced an exacerbation requiring start of or increase in systemic oral corticosteroid therapy and/or hospitalization during the last month (ATS COPD Guidelines 2004)
6. Left ventricular dysfunction as measured by:

1. Screening echocardiographic evidence of left ventricular systolic dysfunction (left ventricular ejection fraction (LVEF) \< 40%), or
2. Screening echocardiographic evidence of left ventricular diastolic dysfunction \> moderate (i.e., \> Grade 2), or
3. Any history of pulmonary capillary wedge pressure (PCWP), left atrial pressure (LAP) or left ventricular end diastolic pressure (LVEDP) \> 18 mm Hg as measured during cardiac catheterization within the past 6 months unless documented to have resolved by a subsequent cardiac catheterization
7. Clinically significant valvular heart disease that may contribute to PH, including mild or greater aortic valvular disease (aortic stenosis or regurgitation) and/or moderate or greater mitral valve disease (mitral stenosis or regurgitation), or status post mitral valve replacement
8. Use within 30 days of screening or current use of approved PH medications such as sildenafil or bosentan (use of Cialis® or Viagra® for erectile dysfunction is permitted)
9. Use of investigational drugs or devices within 30 days prior to enrollment into the study
10. Any underlying medical or psychiatric condition that, in the opinion of the Investigator, makes the subject an unsuitable candidate for the study
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bellerophon Pulse Technologies

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ashika Ahmed, MD

Role: STUDY_DIRECTOR

Bellerophon Therapeutics

Locations

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Jasper Summit Research LLC

Jasper, Alabama, United States

Site Status

Clinical Trial Connection

Flagstaff, Arizona, United States

Site Status

Pulmonary Associates P.A.

Phoenix, Arizona, United States

Site Status

Radin Cardiovascular Medical Associates

Newport Beach, California, United States

Site Status

Western Connecticut Medical Group PC

Danbury, Connecticut, United States

Site Status

Waterbury Pulmonary Associates

Waterbury, Connecticut, United States

Site Status

Bay Area Chest Physicians

Clearwater, Florida, United States

Site Status

Gary J. Richmond, MD, PA

Fort Lauderdale, Florida, United States

Site Status

East Coast Institute for Research

Jacksonville, Florida, United States

Site Status

Pulmonary Disease Specialists PA

Kissimmee, Florida, United States

Site Status

San Marcus Research Clinic Inc.

Miami, Florida, United States

Site Status

St. Paul Medical Research Center Inc.

Miami, Florida, United States

Site Status

IMIC, Inc.

Miami, Florida, United States

Site Status

Elite Clinical Research

Miami, Florida, United States

Site Status

South Florida Research Phase I-IV

Miami, Florida, United States

Site Status

Health & Life Research Solutions Inc.

Miami, Florida, United States

Site Status

Advanced Research Institute, Inc.

New Port Richey, Florida, United States

Site Status

Central Florida Pulmonary Group, P.A.

Orlando, Florida, United States

Site Status

Bassette Medical Research Inc.

Sebring, Florida, United States

Site Status

Research Alliance

St. Petersburg, Florida, United States

Site Status

Concept Clinical Trials, LLC

Tamarac, Florida, United States

Site Status

Axcess Medical Research

Wellington, Florida, United States

Site Status

Florida Premier Research Institute

Winter Park, Florida, United States

Site Status

River Birch Research Alliance LLC

Blue Ridge, Georgia, United States

Site Status

Medical Associates of North Georgia

Canton, Georgia, United States

Site Status

Veritas Clinical Specialties, Ltd

Topeka, Kansas, United States

Site Status

Graves-Gilbert Clinic

Bowling Green, Kentucky, United States

Site Status

Kentucky Research Group

Louisville, Kentucky, United States

Site Status

MedPharmics LLC

Metairie, Louisiana, United States

Site Status

Physician HealthCare Network, PC

Port Huron, Michigan, United States

Site Status

Montefiore Medical Center-Weiler Division

The Bronx, New York, United States

Site Status

American Health Research

Charlotte, North Carolina, United States

Site Status

University Hospitals Case Medical Center

Cleveland, Ohio, United States

Site Status

Temple Lung Center Pulmonary & Critical Care Medicine

Philadelphia, Pennsylvania, United States

Site Status

Lowcountry Lung and Critical Care

Charleston, South Carolina, United States

Site Status

Neem Research Group Inc

Columbia, South Carolina, United States

Site Status

Gaffney Pharmaceutical Research

Gaffney, South Carolina, United States

Site Status

Greenville Pharmaceutical Research

Greenville, South Carolina, United States

Site Status

Clinical Research of Rock Hill

Rock Hill, South Carolina, United States

Site Status

Spartanburg Medical Research

Spartanburg, South Carolina, United States

Site Status

Pioneer Research Solutions, Inc.

Sugar Land, Texas, United States

Site Status

Pulmonary Associates of Richmond Inc

Richmond, Virginia, United States

Site Status

Zain Research LLC

Richland, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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IK-7002-COPD-201

Identifier Type: -

Identifier Source: org_study_id

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