Trial Outcomes & Findings for REPAIR: Right vEntricular Remodeling in Pulmonary ArterIal hypeRtension (NCT NCT02310672)

NCT ID: NCT02310672

Last Updated: 2025-03-30

Results Overview

Change from baseline in RVSV assessed by cardiac magnetic resonance imaging (MRI) from pulmonary artery flow was reported at Week 26. Primary analysis were based on interim results as pre-planned and the primary outcome measures data table reported is finalized as is.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

89 participants

Primary outcome timeframe

Baseline and Week 26

Results posted on

2025-03-30

Participant Flow

Total 112 participants were screened out of them 89 participants were enrolled in the study and of which 87 participants received study medication. Two participants who did not receive study treatment were wrongly classified as enrolled by the sites.

Participant milestones

Participant milestones
Measure
Macitentan 10 mg
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Overall Study
STARTED
87
Overall Study
COMPLETED
72
Overall Study
NOT COMPLETED
15

Reasons for withdrawal

Reasons for withdrawal
Measure
Macitentan 10 mg
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Overall Study
Death
1
Overall Study
Lost to Follow-up
1
Overall Study
Withdrawal by Subject
1
Overall Study
Sponsor's decision
12

Baseline Characteristics

REPAIR: Right vEntricular Remodeling in Pulmonary ArterIal hypeRtension

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Macitentan 10 mg
n=87 Participants
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Age, Continuous
45.9 years
STANDARD_DEVIATION 14.48 • n=93 Participants
Sex: Female, Male
Female
70 Participants
n=93 Participants
Sex: Female, Male
Male
17 Participants
n=93 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=93 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
72 Participants
n=93 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
14 Participants
n=93 Participants
Race/Ethnicity, Customized
Black or African American
1 Participants
n=93 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants
n=93 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
Race/Ethnicity, Customized
Asian
26 Participants
n=93 Participants
Race/Ethnicity, Customized
White
46 Participants
n=93 Participants
Race/Ethnicity, Customized
Other
0 Participants
n=93 Participants
Race/Ethnicity, Customized
Unknown or Not Reported
14 Participants
n=93 Participants
Region of Enrollment
FRANCE
14 Participants
n=93 Participants
Region of Enrollment
GERMANY
12 Participants
n=93 Participants
Region of Enrollment
ISRAEL
2 Participants
n=93 Participants
Region of Enrollment
ITALY
3 Participants
n=93 Participants
Region of Enrollment
MALAYSIA
8 Participants
n=93 Participants
Region of Enrollment
NETHERLANDS
12 Participants
n=93 Participants
Region of Enrollment
RUSSIAN FEDERATION
11 Participants
n=93 Participants
Region of Enrollment
SINGAPORE
9 Participants
n=93 Participants
Region of Enrollment
UNITED KINGDOM
3 Participants
n=93 Participants
Region of Enrollment
UNITED STATES
6 Participants
n=93 Participants
Region of Enrollment
Hong Kong
7 Participants
n=93 Participants

PRIMARY outcome

Timeframe: Baseline and Week 26

Population: The Modified full analysis set (mFAS) included of all screened participants who received at least one dose of study drug and who had a baseline as well as a post-baseline measurement taken between 16 weeks and 30 weeks of treatment.

Change from baseline in RVSV assessed by cardiac magnetic resonance imaging (MRI) from pulmonary artery flow was reported at Week 26. Primary analysis were based on interim results as pre-planned and the primary outcome measures data table reported is finalized as is.

Outcome measures

Outcome measures
Measure
Macitanten 10 mg
n=42 Participants
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Change From Baseline in Right Ventricular Stroke Volume (RVSV) to Week 26
15.17 milliliters (mL)
Standard Error 2.75

PRIMARY outcome

Timeframe: Baseline and Week 26

Population: mFAS included of all screened participants who received at least one dose of study drug and who had a baseline as well as a post-baseline measurement taken between 16 weeks and 30 weeks of treatment.

Ratio of Week 26 to baseline PVR as assessed by RHC was reported. PVR represents the resistance against which the right ventricle needs to pump. PVR is determined by right heart catheterization (RHC). PVR was calculated as 80\*(Mean pulmonary arterial pressure \[mPAP\] -\[Pulmonary capillary wedge pressure {PCWP} or Left ventricular end diastolic pressure {LVEDP} if PCWP not available/cardiac output \[CO\]). Primary analysis were based on interim results as pre-planned and the primary outcome measures data table reported is finalized as is.

Outcome measures

Outcome measures
Measure
Macitanten 10 mg
n=42 Participants
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Ratio of Week 26 to Baseline Pulmonary Vascular Resistance (PVR)
0.63 Ratio
Geometric Coefficient of Variation 0.11

SECONDARY outcome

Timeframe: Baseline to Week 26

Population: Safety set included all screened participants who received at least one dose of study drug. Here 'N' (number of participants analyzed) signifies the number of participants evaluable for this outcome measure.

Change from baseline to Week 26 in RVEDV assessed by cardiac MRI was reported.

Outcome measures

Outcome measures
Measure
Macitanten 10 mg
n=78 Participants
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Change From Baseline in Right Ventricular End Diastolic Volume (RVEDV) to Week 26
-6.22 mL
Interval -12.5 to 0.07

SECONDARY outcome

Timeframe: Baseline to Week 26

Population: Safety set included all screened participants who received at least one dose of study drug. Here 'N' (number of participants analyzed) signifies the number of participants evaluable for this outcome measure.

Change from baseline to Week 26 in RVESV assessed by cardiac MRI was reported.

Outcome measures

Outcome measures
Measure
Macitanten 10 mg
n=78 Participants
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Change From Baseline in Right Ventricular End Systolic Volume (RVESV) to Week 26
-16.39 mL
Interval -20.56 to -12.21

SECONDARY outcome

Timeframe: Baseline to Week 26

Population: Safety set included all screened participants who received at least one dose of study drug. Here 'N' (number of participants analyzed) signifies the number of participants evaluable for this outcome measure.

Change from baseline to Week 26 in RVEF based on pulmonary artery flow assessed by cardiac MRI was reported.

Outcome measures

Outcome measures
Measure
Macitanten 10 mg
n=72 Participants
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Change From Baseline in Right Ventricular Ejection Fraction (RVEF) to Week 26 (% Blood Volume)
10.14 Percentage of blood volume
Interval 7.46 to 12.83

SECONDARY outcome

Timeframe: Baseline to Week 26

Population: Safety set included all screened participants who received at least one dose of study drug. Here 'N' (number of participants analyzed) signifies the number of participants evaluable for this outcome measure.

Change from baseline to Week 26 in RV mass assessed by cardiac MRI was reported.

Outcome measures

Outcome measures
Measure
Macitanten 10 mg
n=78 Participants
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Change From Baseline in Right Ventricle (RV) Mass to Week 26
-10.10 Grams
Interval -13.81 to -6.39

SECONDARY outcome

Timeframe: Baseline to Week 26

Population: Safety set included all screened participants who received at least one dose of study drug. Here 'N' (number of participants analyzed) signifies the number of participants evaluable for this outcome measure.

6MWD is a non-encouraged test performed in a 30 meter (m) long flat corridor, where the participant is instructed to walk as far as possible, back and forth around two cones, with the permission to slow down, rest, or stop if needed. This test is used to assess exercise capacity. The test was performed about 30 minutes after study drug administration. Any increase in the walk distance was considered improvement from baseline.

Outcome measures

Outcome measures
Measure
Macitanten 10 mg
n=83 Participants
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Change From Baseline in Six-minutes Walk Distance (6MWD) to Week 26
38.85 Meters
Standard Error 7.37

SECONDARY outcome

Timeframe: Baseline to Week 26

Population: Safety Set included all screened participants who received at least one dose of study drug.

WHO FC is a classification which reflects disease severity based on symptoms. WHO Functional Classification of pulmonary hypertension comprises of Class I (participants with pulmonary hypertension but without resulting limitation of physical activity), II (participants with pulmonary hypertension resulting in slight limitation of physical activity), III (participants with pulmonary hypertension resulting in marked limitation of physical activity) and IV (participants with pulmonary hypertension with inability to carry out any physical activity without symptoms). Changes from baseline to Week 26 included: improvement (change from a higher to a lower FC), worsening (change from a lower to a higher FC) or unchanged/stable (same FC at baseline and at the post-baseline time point).

Outcome measures

Outcome measures
Measure
Macitanten 10 mg
n=87 Participants
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Change From Baseline in World Health Organization Functional Class (WHO FC) to Week 26
Missing WHO FC
5 Participants
Change From Baseline in World Health Organization Functional Class (WHO FC) to Week 26
Worsened WHO FC
1 Participants
Change From Baseline in World Health Organization Functional Class (WHO FC) to Week 26
Unchanged WHO FC
35 Participants
Change From Baseline in World Health Organization Functional Class (WHO FC) to Week 26
Improved WHO FC
46 Participants

Adverse Events

Macitentan 10 mg

Serious events: 15 serious events
Other events: 57 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Macitentan 10 mg
n=87 participants at risk
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Blood and lymphatic system disorders
Anaemia
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Blood and lymphatic system disorders
Haemolytic Anaemia
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Blood and lymphatic system disorders
Iron Deficiency Anaemia
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Cardiac disorders
Acute Myocardial Infarction
2.3%
2/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Cardiac disorders
Angina Pectoris
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Cardiac disorders
Atrial Fibrillation
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Cardiac disorders
Cardiac Arrest
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Cardiac disorders
Coronary Artery Disease
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Cardiac disorders
Right Ventricular Failure
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Cardiac disorders
Ventricular Hypokinesia
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Gastrointestinal disorders
Rectal Haemorrhage
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
General disorders
Therapeutic Response Decreased
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Immune system disorders
Hypersensitivity
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Infections and infestations
Cholangitis Infective
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Infections and infestations
Cytomegalovirus Infection
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Infections and infestations
Escherichia Bacteraemia
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Infections and infestations
Herpes Zoster
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Infections and infestations
Pneumonia
3.4%
3/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Infections and infestations
Sepsis
2.3%
2/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Infections and infestations
Urinary Tract Infection
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Metabolism and nutrition disorders
Hypoglycaemia
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Musculoskeletal and connective tissue disorders
Rheumatoid Arthritis
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Musculoskeletal and connective tissue disorders
Systemic Lupus Erythematosus
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Pancreatic Carcinoma
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Nervous system disorders
Syncope
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Renal and urinary disorders
Acute Kidney Injury
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Reproductive system and breast disorders
Dysfunctional Uterine Bleeding
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Reproductive system and breast disorders
Dysmenorrhoea
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Reproductive system and breast disorders
Menorrhagia
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Reproductive system and breast disorders
Pelvic Haemorrhage
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Respiratory, thoracic and mediastinal disorders
Dyspnoea
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Respiratory, thoracic and mediastinal disorders
Epistaxis
1.1%
1/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Respiratory, thoracic and mediastinal disorders
Pulmonary Arterial Hypertension
2.3%
2/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Respiratory, thoracic and mediastinal disorders
Pulmonary Embolism
2.3%
2/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.

Other adverse events

Other adverse events
Measure
Macitentan 10 mg
n=87 participants at risk
Participants received macitentan 10 milligrams (mg) tablets once daily until the premature discontinuation of study drug or end of treatment (EOT) on the day of the last dose of study drug at Week 52.
Gastrointestinal disorders
Diarrhoea
9.2%
8/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Gastrointestinal disorders
Nausea
6.9%
6/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
General disorders
Oedema Peripheral
21.8%
19/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
General disorders
Pyrexia
8.0%
7/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Infections and infestations
Nasopharyngitis
6.9%
6/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Infections and infestations
Upper Respiratory Tract Infection
11.5%
10/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Investigations
Haemoglobin Decreased
11.5%
10/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Musculoskeletal and connective tissue disorders
Back Pain
8.0%
7/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Musculoskeletal and connective tissue disorders
Myalgia
10.3%
9/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Musculoskeletal and connective tissue disorders
Pain in Extremity
6.9%
6/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Nervous system disorders
Dizziness
13.8%
12/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Nervous system disorders
Headache
20.7%
18/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Respiratory, thoracic and mediastinal disorders
Cough
11.5%
10/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Respiratory, thoracic and mediastinal disorders
Nasal Congestion
9.2%
8/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.
Vascular disorders
Flushing
5.7%
5/87 • Up to 420 Days
Safety Set included all screened participants who received at least one dose of study drug.

Additional Information

Director

Actelion Pharmaceuticals Ltd

Phone: 844-434-4210

Results disclosure agreements

  • Principal investigator is a sponsor employee If an investigator wishes to publish information from the study, a copy of the manuscript must be provided to the sponsor for review at least 60 days before submission for publication or presentation. If requested by the sponsor in writing, the investigator will withhold such publication for up to an additional 60 days.
  • Publication restrictions are in place

Restriction type: OTHER