This is a multi-center, Phase 2 Long-Term, Open Label Extension (OLE) Study to assess the safety and tolerability of pemziviptadil (PB1046) at an optimally titrated dose. This is a Long-Term, Open label Extension (OLE) Study for subjects with (PAH), having participated in double-blind Study PB1046-PT-CL-0004. The study will include adult subjects previously diagnosed with symptomatic PAH, who are receiving background clinician-directed therapy for PAH. During this period, subjects will continue to be followed for safety and tolerability, as well as for periodic efficacy, quality of life data and immunogenicity. The study will continue per the schedule of events until such time when pemziviptadil (PB1046) is able to be self-administered, becomes commercially available to the subjects in a particular country or region, or the sponsor terminates the study due to lack of efficacy, safety or other reasons.
Subjects entering this study will enter from the double-blind Study PB1046-PT-CL-0004. The starting dose level of pemziviptadil (PB1046) for all subjects in this parent study was a sub-therapeutic or minimally effective dose (MED) of 0.2 mg/kg, administered by SC injection. Subjects were randomized into the MED) Group or a dose-titration group. In the dose-titration group, individual subjects were titrated up to their maximum tolerated dose (MTD) in a blinded fashion, with the objective of titrating subjects up to a dose of at least 1.2 mg/kg or higher in the MTD Group, while subjects in the MED Group remained at the MED level of 0.2 mg/kg, and underwent "sham dose-titration" to maintain the blind. Subjects entering the 0006 trial prior to implementation of this protocol amendment will remain blinded until such time that open label dosing will not unblind the 0004 study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
25
Once-weekly subcutaneous injection
University of California San Diego
La Jolla, California, United States
University of California - Davis
Sacramento, California, United States
University of Miami - Pulmonary Research Center
Miami, Florida, United States
Emory University, The Emory Clinic
Atlanta, Georgia, United States
University of Iowa Hospitals and Clinics
Iowa City, Iowa, United States
University of Kansas Medical Center
Kansas City, Kansas, United States
Tufts Medical Center
Boston, Massachusetts, United States
Brigham and Women's Hospital
Boston, Massachusetts, United States
NYU Langone Health
New York, New York, United States
University of Rochester Medical Center
Rochester, New York, United States
...and 6 more locations
Incidence and Severity of Adverse Events
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Incidence of Clinical Laboratory Abnormalities
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change in Diastolic Blood Pressure from baseline
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change in Systolic Blood Pressure from baseline
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change in Oral Body Temperature from baseline
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change in Respiratory Rate from baseline
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change in Heart Rate from baseline
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
12-Lead ECG - Incidence of clinically significant abnormal ECG findings as measured by 12 Lead ECG
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Incidence of Immunogenicity
Incidence of positive immunogenicity results after receipt of study drug
Time frame: Duration of extension study - Starting up to 30 days prior to first dose of study drug in original study (PB1046-PT-CL-0004/0005) and completing 28 days after last dose.
Survival
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change from baseline in 6MWD (6 minute walk distance test)
Measured in meters walked in 6 minutes.
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change from baseline in NT-proBNP
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change from baseline in NYHA/WHO Functional Class (FC)
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change from baseline in emPHasis-10 (Health Related Quality of Life) score
Scores, which assess breathlessness, fatigue, control and confidence, range from 0 to 50, higher scores indicate worse quality of life.
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change from baseline in Borg Dyspnea Index (BDI)
BDI scale as measured from 0 to 10 (0 being no breathlessness and 10 being maximal breathlessness)
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Incidence of Clinical Worsening
As defined by any one of the following: 1. All cause mortality; 2. Hospitalization due to worsening PAH; 3. Initiation of parenteral prostacyclin; 4. Any three of the following: 15% decrease in 6MWD, Functional class III or IV symptoms, Addition of PAH therapy, Worsening right heart failure
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.
Change in REVEAL Registry Risk Calculator Score
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Risk scores range from 0 (Lowest risk) to 22 (Highest risk) in PAH subjects
Time frame: Duration of extension study - Starting the day of first dose and completing 28 days after last dose.