Trial Outcomes & Findings for Fluoxetine in Pulmonary Arterial Hypertension (PAH) Trial (NCT NCT03638908)

NCT ID: NCT03638908

Last Updated: 2020-06-26

Results Overview

Change in PVR between baseline and follow-up will be utilized. PVR is calculated as \[(Pulmonary Artery mean - wedge) / Fick Cardiac Output\]. Fick CO will be used in computing PVR over thermodilution because Fick appears to have greater precision (but not accuracy). The calculation of PVR above is measured in woods unit. Change is derived by getting the difference between baseline and week 24 PVR (Week 24 minus Baseline). mean is then computed by getting the average of the change

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

8 participants

Primary outcome timeframe

Baseline and Week 24

Results posted on

2020-06-26

Participant Flow

Subjects were recruited solely from the clinic from November 2013 to November 2016

This was an open label study and all subjects were assigned to receive Fluoxetine.

Participant milestones

Participant milestones
Measure
Fluoxetine
Dosing will be * Week 1-4: 20 mg daily * Week 5-8: 40 mg daily * Week 9-12: 60 mg daily * Week 13-24: 80 mg daily Fluoxetine
Overall Study
STARTED
8
Overall Study
COMPLETED
7
Overall Study
NOT COMPLETED
1

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Fluoxetine in Pulmonary Arterial Hypertension (PAH) Trial

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Fluoxetine
n=8 Participants
Dosing will be * Week 1-4: 20 mg daily * Week 5-8: 40 mg daily * Week 9-12: 60 mg daily * Week 13-24: 80 mg daily Fluoxetine
Age, Continuous
44.5 years
STANDARD_DEVIATION 10.7 • n=5 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Race/ethnicity · White non-hispanic
5 Participants
n=5 Participants
Race/Ethnicity, Customized
Race/ethnicity · Hispanic
3 Participants
n=5 Participants
Race/Ethnicity, Customized
Race/ethnicity · African American
0 Participants
n=5 Participants
Region of Enrollment
United States
8 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline and Week 24

Population: 6 out of the 8 subjects enrolled had complete- baseline and week 24- data for analysis

Change in PVR between baseline and follow-up will be utilized. PVR is calculated as \[(Pulmonary Artery mean - wedge) / Fick Cardiac Output\]. Fick CO will be used in computing PVR over thermodilution because Fick appears to have greater precision (but not accuracy). The calculation of PVR above is measured in woods unit. Change is derived by getting the difference between baseline and week 24 PVR (Week 24 minus Baseline). mean is then computed by getting the average of the change

Outcome measures

Outcome measures
Measure
Fluoxetine
n=6 Participants
Dosing will be * Week 1-4: 20 mg daily * Week 5-8: 40 mg daily * Week 9-12: 60 mg daily * Week 13-24: 80 mg daily
Fluoxetine- Week 24
subject data at week 24
Pulmonary Vascular Resistance (PVR)
6.7 woods unit
Standard Deviation 2.7

SECONDARY outcome

Timeframe: Baseline and Week 24

Population: unable to adequately analyze outcome as there were several missing data- values provided below are not meaningful.

Urine for spot urine 5-HIAA will be collected at baseline and Week 24. Subjects will be on diet restriction 72 hours prior to urine collection. Sample will be the first morning urine on the visit day. Sample will be brought to site and then sent to affiliate outside laboratory for processing. 5HIAA results are expressed as a ratio to creatinine excretion in the unit "mg/g creatinine" Change 5-HIAA is derived by getting the difference between baseline and week 24 5HIAA results (Week 24 minus Baseline). mean is then computed by getting the average of the change

Outcome measures

Outcome measures
Measure
Fluoxetine
n=5 Participants
Dosing will be * Week 1-4: 20 mg daily * Week 5-8: 40 mg daily * Week 9-12: 60 mg daily * Week 13-24: 80 mg daily
Fluoxetine- Week 24
subject data at week 24
5-HIAA (HYDROXYINDOLE ACETIC ACID) Level
0.375 mg/g CRT
Standard Deviation 0.182

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and Week 24

Population: unable to analyze outcome as this sub-study was dependent on obtaining additional funding- samples were collected but not processed to provide result

About 20ml blood will be obtained for plasma and serum at Baseline and Week 24. This will be placed in a red-top tube (serum, at least 1 ml) and blue-top tube. For the plasma tests, a plasma volume of 750 microL is required. Samples will be sent together, as a batch of 50 is required, on dry ice via overnight courier. Plasma will be obtained by drawing blood into a blue-top citrated tube, inverting the tube 6 times, and then centrifuging at 2000g for 10 minutes. The platelet poor plasma will be drawn off, and then re-centrifuged for 10 minutes before freezing.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: baseline and 24

Population: 6 out of total enrolled had complete data for analysis

Exercise capacity will be measure using the 6-minute walk test. Data collected at baseline and 24 were analyzed. The test will follow the ATS guidelines for 6MWT at all time.

Outcome measures

Outcome measures
Measure
Fluoxetine
n=6 Participants
Dosing will be * Week 1-4: 20 mg daily * Week 5-8: 40 mg daily * Week 9-12: 60 mg daily * Week 13-24: 80 mg daily
Fluoxetine- Week 24
n=6 Participants
subject data at week 24
Exercise Capacity
380 meters
Standard Deviation 80.7
393 meters
Standard Deviation 78.6

OTHER_PRE_SPECIFIED outcome

Timeframe: baseline and 24

Population: analysis was not done as study primary endpoint was not met- since primary endpoint was not met, no further analyses were completed

Functional class will be measured using the WHO functional class assessment. This is graded from WHO FC I to FC IV. Assessment will be completed by an investigator on the study at every visit.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: baseline and Week 24.

Population: 7 subjects of the total enrolled were included in the descriptive analysis. 1 subject did not complete the study

Patient reported outcome will be assessed using the Quick Inventory of Depressive Symptomatology (16-Item) (Self-Report) (QIDS-SR16) completed at baseline, week 12 and Week 24; baseline and week 24 reported. Each question is scored from minimum of 0 to a maximum of 3; total score ranges from 0 to 42. With zero being better outcome and 42 being severe outcome

Outcome measures

Outcome measures
Measure
Fluoxetine
n=7 Participants
Dosing will be * Week 1-4: 20 mg daily * Week 5-8: 40 mg daily * Week 9-12: 60 mg daily * Week 13-24: 80 mg daily
Fluoxetine- Week 24
n=7 Participants
subject data at week 24
Quick Inventory of Depressive Symptomatology
4.7 score on a scale
Standard Deviation 2.3
4.3 score on a scale
Standard Deviation 3.3

OTHER_PRE_SPECIFIED outcome

Timeframe: baseline

Population: analysis was not done as study primary endpoint was not met- since primary endpoint was not met, no further analyses were completed

PGIS questionnaire will be administered for global assessment of severity. This questionnaire is categorical and measures outcome from "none" being best outcome to "severe" being the worst outcome

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Week 12 and Week 24.

Population: analysis was not done as study primary endpoint was not met- since primary endpoint was not met, no further analyses were completed

Global assessment of severity will be determined using Clinician global impression of severity - symptoms (CGIS). This questionnaire is categorical and measures outcome from "none" being best outcome to "severe" being the worst outcome

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: baseline, Week 12 and Week 24.

Population: analysis was not done as study primary endpoint was not met- since primary endpoint was not met, no further analyses were completed

Patient reported outcome will also be assessed using SF-36 completed at baseline, Week 12 and Week 24. The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability. The eight sections are: vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Weeks 12 and 24

Population: analysis was not done as study primary endpoint was not met- since primary endpoint was not met, no further analyses were completed

CGI-change questionnaire will be completed for global assessment of severity. This questionnaire is categorical and measures outcome from "very much better" being best outcome to "very much worse" being the worst outcome

Outcome measures

Outcome data not reported

Adverse Events

Fluoxetine

Serious events: 0 serious events
Other events: 8 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Fluoxetine
n=8 participants at risk
Dosing will be * Week 1-4: 20 mg daily * Week 5-8: 40 mg daily * Week 9-12: 60 mg daily * Week 13-24: 80 mg daily Fluoxetine
General disorders
headaches
50.0%
4/8 • 7 months
General disorders
excessive yawning
25.0%
2/8 • 7 months
Psychiatric disorders
anxiety
25.0%
2/8 • 7 months
Gastrointestinal disorders
diarrhea
37.5%
3/8 • 7 months
Respiratory, thoracic and mediastinal disorders
acute bronchitis
25.0%
2/8 • 7 months
General disorders
fatigue
25.0%
2/8 • 7 months
Cardiac disorders
increased palpitations
25.0%
2/8 • 7 months
General disorders
dizziness
25.0%
2/8 • 7 months

Additional Information

Kelly Chin, MD

UTSouthwestern medical center

Phone: 2146456493

Results disclosure agreements

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