Clinical trial NCT04691154: A Phase 3 Study to Evaluate the Safety and Tolerability of L606 in Subjects With PAH or PH-ILD
Official title: A Phase 3, 2-Part, Open-Label Study to Evaluate the Safety and Tolerability of Liposomal Treprostinil Inhalation Suspension (L606) in Subjects With Pulmonary Arterial Hypertension or Pulmonary Hypertension Associated With Interstitial Lung Disease
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: PHASE3
Conditions: Pulmonary Arterial Hypertension
Pulmonary Hypertension Due to Lung Diseases
Keywords: treprostinil
Pulmonary Arterial Hypertension
inhalation
Pulmonary Hypertension Due to Lung Diseases
Lead sponsor: Liquidia Technologies, Inc.
Sponsor class: INDUSTRY
Collaborators: name: PPD Development, LP
First posted: 2020-12-31
Enrollment: 28
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Cohort A: Tyvaso stabilized PAH or PH-ILD patients Cohort B: Prostacyclin naive - PAH patients
Primary purpose: TREATMENT

Brief summary: This Phase 3, 2-part, open-label, multicenter study aims to demonstrate the safety and tolerability of L606 in patients with PAH or PH-ILD. The study will determine the short-term and long-term safety and tolerability of L606 in this patient population; also evaluate the steady-state pharmacokinetics (PK) of L606 as compared to Tyvaso, effects on exercise ability, quality of life, and treatment satisfaction with L606.

Detailed description: This Phase 3, 2-part, open-label, multicenter study aims to demonstrate the safety and tolerability of repeated doses of L606 in patients with PAH or PH-ILD. The current Phase 3 study will help determine the short-term and long-term safety and tolerability of L606 in this patient population. The study will also evaluate the steady-state pharmacokinetics (PK) of L606 as compared to Tyvaso, effects on exercise ability (6-minute walk distance \[6MWD\] and Borg Dyspnea Score), quality of life (QoL), and treatment satisfaction with L606.

Subjects who meet all the inclusion criteria and none of the exclusion criteria will be enrolled to one of the 2 cohorts:

Cohort A: Subjects with PAH or PH-ILD receiving prior stable doses of Tyvaso (4 times daily) and willing to switch to L606 (twice daily).

Cohort B: Subjects with PAH (not initially on prostacyclin therapy) who are likely to receive clinical benefit from inhaled treprostinil based on the opinion of the investigator.

Cohort A subjects will sequentially participate in the MSP for 2 weeks and the OEP for 46 weeks. A subset of up to 15 subjects from Cohort A will also participate in a PK substudy. Cohort B subjects will sequentially participate in the MSP for 12 weeks and the OEP for 36 weeks.

Eligibility criteria: Key Inclusion Criteria:

1. Able to understand and complete study requirements and provide written informed consent.
2. Males and females ≥18 and ≤80 years of age at the time of informed consent. All sexually active male subjects and female subjects of childbearing potential must use an acceptable, highly effective method of contraception.
3. Diagnosed with

   1. PAH belonging to at least 1 of the following subgroups of Group 1 pulmonary hypertension (PH) per European Society of Cardiology/European Respiratory Society Guidelines for the diagnosis and treatment of PH at least 1 year prior to screening. or
   2. PH-ILD Group 3 European Society of Cardiology/European Respiratory Society Guidelines for the diagnosis and treatment of PH. Subjects with Group 3 PH that is not related to underlying ILD are not eligible.
4. Subjects with PAH: Documentation of having PAH as confirmed by RHC within 12 months prior to screening and meeting the following criteria:

   i. Mean PAP \>20 mmHg. ii. Pulmonary arterial wedge pressure ≤15 mmHg. iii. Pulmonary vascular resistance \>3 Wood units. Subjects with PH-ILD: Confirmation of the underlying ILD must be based on HRCT imaging conducted within the past 12 months prior to randomization with demonstration of diffuse parenchymal lung disease and documented by the Investigator or radiology report. Subjects may have any form of ILD or CPFE.
5. NYHA functional class II, III, or IV at the screening visit.
6. Can complete a screening 6MWD of ≥150 meters
7. For subjects with PAH: \>65% of predicted and FEV1/FVC ratio \>65% at screening. For subjects with PH-ILD: \>40% of predicted and FEV1/FVC ratio \>70% at screening.

Key Exclusion Criteria:

1. LVEF of ≤45% on a historical echocardiogram within 6 months of screening.
2. History of sleep apnea, or left-sided heart disease (including but not limited to aortic or mitral valve disease, pericardial constriction, restrictive or congestive cardiomyopathy, or coronary artery disease) per investigator's discretion.
3. Experienced an acute exacerbation of disease or hospitalization for any reason within 30 days of signing the ICF or prior to baseline.
4. Systolic blood pressure \<90 mmHg or ≥160 mmHg at baseline.
5. Screening electrocardiogram (ECG) with QTcF \>525 ms.
6. Musculoskeletal disorder (eg, arthritis affecting the lower limbs, recent hip or knee joint replacement) or any disease that would likely be the primary limit to ambulation or subject is connected to a machine that is not portable enough to allow for a 6MWT.
7. Alanine aminotransferase or aspartate aminotransferase levels \>3 × upper limit of normal reference range, clinically significant liver disease/dysfunction, or known Child-Pugh Class C hepatic disease.
8. Estimated glomerular filtration rate \<30 mL/min/1.73 m2 or requires dialysis.

Primary outcomes:
measure: Safety/Tolerability assessed by incidence of treatment-emergent AEs/SAEs
timeFrame: 2 weeks
measure: Safety/Tolerability assessed by incidence of treatment-emergent AEs/SAEs
timeFrame: 12 weeks
measure: Safety/Tolerability assessed by incidence of treatment-emergent AEs/SAEs (long-term)
timeFrame: 48 weeks
Secondary outcomes:
measure: Safety/Tolerability assessed by incidence of treatment-emergent AEs/SAEs
timeFrame: 12 months
measure: Pharmacokinetics assessed by steady-state PK parameters of treprostinil from Tyvaso and L606
timeFrame: 2 weeks
Other outcomes:
measure: Efficacy of L606 assessed by 6MWD at steady-state morning trough and peak concentrations of treprostinil
timeFrame: 2 weeks and 12 weeks
measure: Efficacy of L606 assessed by 6MWD at steady-state morning trough and peak concentrations of treprostinil (long-term)
timeFrame: 48 weeks
measure: Cohort A and Cohort B: Quality of Life assessed by PAH-specific Quality of Life questionnaire Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR).
timeFrame: 2 weeks, 12 weeks, 48 weeks
measure: Treatment satisfaction of L606 assessed by Treatment Satisfaction Questionnaire (TSQM)
timeFrame: 2 weeks, 12 weeks and 48 weeks
measure: Efficacy of L606 assessed by Borg Dyspnea Score
timeFrame: 2 weeks, 12 weeks and 48 weeks
measure: Efficacy of L606 assessed by New York Heart Association (NYHA) functional class
timeFrame: 2 weeks, 12 weeks and 48 weeks
measure: Efficacy of L606 assessed by N-terminal prohormone B-type natriuretic peptide (NT-proBNP)
timeFrame: 2 weeks, 12 weeks and 48 weeks
measure: PAH and PH-ILD symptoms
timeFrame: 2 weeks, 12 weeks and 48 weeks
measure: L606 treatment failure due to worsening of PAH or PH-ILD
timeFrame: 2 weeks, 12 weeks and 48 weeks
Locations:
city: Phoenix
country: United States
facility: Arizona Pulmonary Specialists
state: Arizona
city: Los Angeles
country: United States
facility: VA Greater Los Angeles Healthcare
state: California
city: Jacksonville
country: United States
facility: Mayo Clinic Jacksonville
state: Florida
city: Boston
country: United States
facility: Brigham and Womens Hospital
state: Massachusetts
city: Pittsburgh
country: United States
facility: UPMC Montefiore
state: Pennsylvania
Study officials:
References: