This study assesses the safety and efficacy of bardoxolone methyl relative to placebo in patients with connective tissue disease-associated pulmonary arterial hypertension to determine the recommended dose range and evaluate the change from baseline in 6-minute walk distance (6MWD) following 24 weeks of study participation.
This double-blind, randomized, placebo-controlled trial will study the safety, tolerability, and efficacy of bardoxolone methyl in qualified patients with World Health Organization Group I Connective Tissue Disease Pulmonary Arterial Hypertension (WHO Group I CTD-PAH). Qualified patients will be randomized 1:1 to either bardoxolone methyl or placebo to be administered once daily for 24 weeks. Patients randomized to placebo will remain on placebo throughout the study. Patients randomized to bardoxolone methyl will start at 5 mg and will dose-escalate to 10 mg at Week 4 unless contraindicated clinically. Dose de-escalation is permitted during the study if indicated clinically. All patients in the study will follow the same visit and assessment schedule. Following randomization, patients will be scheduled to be assessed in person during treatment at Weeks 1, 2, 4, 6, 8, 16, and 24 and by telephone contact on Days 3, 10, 21, 31, 38, 84, and 140. Patients will also be scheduled to be assessed at an in person follow up visit at Week 28, four weeks after the end of treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
202
Change From Baseline in Six-minute-walk Distance (6MWD) Relative to Placebo at Week 24
Time frame: Baseline through 24 weeks after participant receives the first dose
Time to First Persistent Clinical Improvement Event
At least one of the following four criteria must have been met: 1. Improvement by at least one WHO functional class coupled with no more than a 15% decrease from baseline in 6MWT 2. Increase from baseline in 6MWT by at least 10% and stability or improvement in the WHO functional class 3. Decrease from baseline in creatine kinase (a surrogate biomarker for muscle injury and inflammation) by at least 10% and no worsening in WHO functional class and no more than a 15% decrease from baseline in 6MWT 4. Improvement in estimated glomerular filtration rate eGFR ≥10% of baseline The persistence of the change in WHO functional class, 6MWT, eGFR, or creatine kinase must be confirmed by a subsequent assessment at least 14 days after the initial assessment, or at the next scheduled assessment. If persistent improvement is confirmed, the date of the event was considered the initial assessment of improved WHO functional class, 6MWT, eGFR, or creatine kinase.
Time frame: Baseline through the end of the study
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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
Regents of The University of California
Fresno, California, United States
University of California San Diego
La Jolla, California, United States
David Geffen School of Medicine UCLA
Los Angeles, California, United States
Pacific Pulmonary Research, Inc.
San Diego, California, United States
Santa Barbara Pulmonary Associates
Santa Barbara, California, United States
Harbor - UCLA Medical Center
Torrance, California, United States
Georgetown University Medical Center - Department of Rheumatology
Washington D.C., District of Columbia, United States
...and 96 more locations