This study assesses the safety and efficacy of bardoxolone methyl relative to placebo in patients with pulmonary hypertension to determine the recommended dose range, evaluate the change from baseline in 6-minute walk distance (6MWD) and determine the effect of Bardoxolone methyl in pulmonary hypertension associated with connective tissue disease, interstitial lung disease, and idiopathic etiologies, including subsets of patients with WHO Group III or WHO Group V PH following 16 weeks of study participation.
The molecular and pharmacological effects of bardoxolone methyl are broad through its induction of Nrf2 and suppression of NF-κB. Bardoxolone methyl may therefore address multiple facets of the pathophysiology of PH because it suppresses activation of proinflammatory mediators, enhances endothelial NO bioavailability, improves metabolic dysfunction, suppresses vascular proliferation, and prevents maladaptive remodeling. Furthermore, while existing therapies primarily target only smooth muscle cells, bardoxolone methyl targets multiple cell types relevant to PH, including endothelial cells, smooth muscle cells, and macrophages. This is a two-part study. Part 1: Part 1 of the study will include a dose-ranging phase and a dose-titration phase. Part 2 (extension period): All patients from Part 1 who complete the 16-week treatment period as planned will be eligible to continue directly into the extension period to evaluate the intermediate and long-term safety and efficacy of bardoxolone methyl.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
166
Banner University Medical Center, Phoenix Advanced Lung Disease Institute
Phoenix, Arizona, United States
Arizona Pulmonary Specialists
Phoenix, Arizona, United States
Cedars Sinai Medical Center
Beverly Hills, California, United States
VA Healthcare System of Greater Los Angeles
Los Angeles, California, United States
University of California Davis Medical Center - Division of Pulmonary and Critical Care
Sacramento, California, United States
Change From Baseline Though Week 16 in 6-Minute Walk Distance (6MWD) for Bardoxolone Methyl Compared to Placebo
Overall treatment effect in exercise capacity, as measured by the total distance walked in 6 minutes (6MWD) mean change from baseline though Week 16. A lower 6MWD reflects greater severity thus, a positive change from baseline suggests an improvement.
Time frame: Baseline through Week 16
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Harbor - UCLA Medical Center
Torrance, California, United States
University of Colorado Denver - Division of Pulmonary Sciences
Aurora, Colorado, United States
South Denver Cardiology Associates, P.C
Littleton, Colorado, United States
Georgetown University Medical Center - Department of Rheumatology
Washington D.C., District of Columbia, United States
Cleveland Clinic of Florida
Weston, Florida, United States
...and 22 more locations