Long Acting Phosphodiesterase 5 Inhibitors as Add-on Therapy for Patients With Pulmonary Hypertension Treated With Prostanoids. - Full Text View

Purpose

Pulmonary arterial hypertension is a chronic disease of the lung blood vessels resulting in constriction and high pressures. Treatment is given with a variety of drugs including the prostanoid class (e.g. epoprostenol, iloprost and the phosphodiesterase 5 (PDE-5) inhibitors (e.g. sildenafil).

Although these drugs are known to be effective alone, little is known about combining them together in various combinations.

In this trial we will add a long-acting PDE-5 inhibitor to the treatment of patients with pulmonary arterial hypertension who currently are receiving only a prostanoid drug.

Condition	Intervention	Phase
Pulmonary Arterial Hypertension	Drug: Tadalafil Drug: Vardenafil	Phase IV

Genetics Home Reference related topics:

pulmonary arterial hypertension

MedlinePlus related topics:

High Blood Pressure Pulmonary Hypertension

ChemIDplus related topics:

Vardenafil Tadalafil

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Non-Randomized, Open Label, Historical Control, Single Group Assignment, Safety/Efficacy Study

Further study details as provided by Rabin Medical Center:

Primary Outcome Measures:

Six minute walking distance [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
Level of pro-NT BNP [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Echo-derived parameters [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
Cardiopulmonary exercise test [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]

Estimated Enrollment:	30
Study Start Date:	August 2008
Estimated Primary Completion Date:	January 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1: Experimental Patients treated with epoprostenol (Flolan) will be given tadalafil (Cialis).	Drug: Tadalafil Orally, titrated to maximum 20mg od
2: Experimental Patients receiving iloprost (Ventavis) will receive vardenafil (Levitra)	Drug: Vardenafil Orally, titrated to 10 mg bid

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

All patients must satisfy current diagnostic criteria for pulmonary artery hypertension based on their historical right heart catheter data (within 3 years of study enrollment): Mean PAP >25mmHg at rest or >30mmHg with exercise, by a PCWP< 15mmHg and by PVR >3 Wood Units.
Currently stable for at least 3 months on prostanoid monotherapy (epoprostenol iv or iloprost inhaled).
Willing and able to participate in all study follow-up procedures.
New York Heart Association (NYHA) Class II-IV.
Six minute walking distance between 100-450 meters at the baseline assessment.
Women of child-bearing age must demonstrate adequate contraception or undergo a pregnancy test.
Patients with congenital heart disease are eligible for inclusion.

Exclusion Criteria:

Functional Class NYHA Class I.
PAH due to chronic pulmonary thromboembolic disease, left heart disease, chronic lung diseases (VC or FEV1 < 60% of predicted) or chronic hypoxia.
Acute intercurrent illness requiring hospital admission in the month proceeding screening.
Any non-PAH medical condition likely to interfere with participation in evaluation of study endpoints, e.g. musculoskeletal disorders.
Any uncontrolled or terminal non-PAH medical condition likely to interfere with completion of the study, according to the judgment of the study physician.
Concomitant therapy with drugs known to interact adversely with the study drug.
Chronic renal failure - creatinine clearance <50ml/min as calculated with the Cockcroft equation.
Current participation in another clinical trial.
Pregnancy or planned pregnancy during the study period.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00705588

Contacts


Contact: Mordechai R Kramer, MD	972-3-937-7221	kremerm@clalit.org.il

Locations


Israel
	Pulmonary Institute, Rabin Medical Center	Not yet recruiting
	Petach Tikva, Israel, 49100
	Sub-Investigator: Benjamin D Fox, BM BCh MRCP

Sponsors and Collaborators

Rabin Medical Center

Investigators


Principal Investigator:	Mordechai R Kramer, MD	Rabin Medical Center

More Information

Responsible Party:	Rabin Medical Center ( Prof MR Kramer )
Study ID Numbers:	RMC084936CTIL
First Received:	June 25, 2008
Last Updated:	June 25, 2008
ClinicalTrials.gov Identifier:	NCT00705588
Health Authority:	Israel: Ministry of Health