Effects of Combination Medical Therapy Followed by BPA on Right Ventricular-PA Coupling and Hemodynamics in CTEPH

NCT ID: NCT05140525

Last Updated: 2025-10-21

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-27

Study Completion Date

2026-12-31

Brief Summary

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The main goal of this study is to determine the effects of combination medical therapy (Riociguat and Macitentan) and balloon pulmonary angioplasty (BPA) on hemodynamics and right ventricular (RV) function (including advanced assessments of RV-pulmonary artery (PA) coupling from invasive hemodynamics) in participants with inoperable or post-PTE residual CTEPH.

Detailed Description

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Recent presented but unpublished results from trials of BPA vs riociguat for inoperable CTEPH (NCT02634203) have demonstrated that BPA provides a more significant hemodynamic benefit than medical therapy. The investigators hypothesize that participants who are treated with upfront combination medical therapy followed by BPA will have significant improvements in their hemodynamics and RV-PA coupling that can be monitored over time.

Conditions

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CTEPH

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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participants with inoperable CTEPH

subject with inoperable Chronic thromboembolic Pulmonary Hypertension

Group Type ACTIVE_COMPARATOR

Macitentan Tablets

Intervention Type DRUG

10 mg oral once daily

Riociguat

Intervention Type DRUG

1 mg to 2.5mg oral three times daily

balloon pulmonary angioplasty

Intervention Type DEVICE

on hemodynamics and RV function (including advanced assessments of RV-PA coupling

post PTE residual CTEPH

Subject with post pulmonary endarterectomy (PTE) residual Chronic Thromboembolic Pulmonary Hypertension

Group Type ACTIVE_COMPARATOR

Macitentan Tablets

Intervention Type DRUG

10 mg oral once daily

Riociguat

Intervention Type DRUG

1 mg to 2.5mg oral three times daily

balloon pulmonary angioplasty

Intervention Type DEVICE

on hemodynamics and RV function (including advanced assessments of RV-PA coupling

Interventions

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Macitentan Tablets

10 mg oral once daily

Intervention Type DRUG

Riociguat

1 mg to 2.5mg oral three times daily

Intervention Type DRUG

balloon pulmonary angioplasty

on hemodynamics and RV function (including advanced assessments of RV-PA coupling

Intervention Type DEVICE

Other Intervention Names

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OPSUMIT Adempas

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 18 years' old
2. Diagnosis of CTEPH
3. Not a candidate for PTE
4. Candidate for BPA based on suitable anatomy and disease burden
5. Treatment-naïve (no CTEPH or pulmonary arterial hypertension (PAH)-specific medical therapies) with plans for initiation of CTEPH/PAH-specific medical therapy and treatment with BPA.
6. Willing and able to give informed consent and adhere to visit/protocol schedules (Consent must be given before any study procedures are performed).

Exclusion Criteria

* Subjects presenting with any of the following will not be included in the trials:

1. Moderate to severe heart disease (LVEF \< 45% or severe LV Hypertrophy)
2. Sarcoidosis
3. Active cancer
4. Sickle cell anemia
5. Liver disease (Childs-Pugh class C)
6. Prisoners
7. Pregnant, planning pregnancy or lactating
8. Conditions that will prohibit MRI scanning (metal in eye, claustrophobia, inability to lie supine)
9. Contraindication to riociguat or macitentan
10. Medical or psychological conditions which, in the opinion of the investigator, might create undue risk to the subject or interfere with the subject's ability to comply with the protocol requirements
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Janssen Pharmaceutica N.V., Belgium

INDUSTRY

Sponsor Role collaborator

Dr Sudarshan Rajagopal

OTHER

Sponsor Role lead

Responsible Party

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Dr Sudarshan Rajagopal

Associate Professor of Medicine

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Sudarshan Rajagopal, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Duke Health System

Locations

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Duke University Medical Center

Durham, North Carolina, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Claudia Salazar

Role: CONTACT

+1 919 660 2026

Facility Contacts

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David Ptashnik, MS

Role: primary

9196682642

Other Identifiers

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Pro00105903

Identifier Type: -

Identifier Source: org_study_id

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