Clinical trial NCT01545336: Anastrozole in Patients With Pulmonary Arterial Hypertension
Official title: A Double-blind, Placebo-controlled Phase II Study of Anastrozole in Patients With Pulmonary Arterial Hypertension
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Pulmonary Arterial Hypertension
Lead sponsor: University of Pennsylvania
Sponsor class: OTHER
First posted: 2012-03-06
Enrollment: 18
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The main purpose of this clinical trial is to study the safety and efficacy of anastrozole in adults diagnosed with pulmonary arterial hypertension (PAH). The study will evaluate how well the drug is tolerated. The study will also evaluate if anastrozole effects estradiol (E2) hormone levels, a sex hormone, and improves the function of the lower right chamber of the heart (right ventricle).


Eligibility criteria: Inclusion Criteria:

* Previous documentation of mean pulmonary artery pressure \> 25 mm Hg with a pulmonary capillary wedge pressure (or left ventricular end-diastolic pressure) \< 16 mm Hg and PVR \> 3 WU at any time before study entry.
* Diagnosis of PAH which is idiopathic, heritable, drug- or toxin-induced, or associated with connective tissue disease, congenital heart disease, portal hypertension, or HIV infection.
* Most recent pulmonary function tests with FEV1/FVC \>50% AND either a) total lung capacity \> 70% predicted or b) total lung capacity between 60% and 70% predicted with no more than mild interstitial lung disease on computerized tomography scan of the chest
* Ability to perform six minute walk testing without limitations in musculoskeletal function or coordination.
* If female, post-menopausal state, defined as:
* \> 50 years old AND
* a) have not menstruated during the preceding 12 months OR
* b) have follicle-stimulating hormone (FSH) levels (\> 40 IU/L) OR
* \< 50 years and FSH (\> 40 IU/L) OR
* having had a bilateral oophorectomy
* Informed consent

Exclusion Criteria:

* Treatment with estrogen or anti-hormone therapy (tamoxifen, fulvestrant, etc.)
* WHO Class IV functional status
* History of breast cancer
* Clinically significant untreated sleep apnea
* Left-sided valvular disease (more than moderate mitral valve stenosis or insufficiency or aortic stenosis or insufficiency), pulmonary artery or valve stenosis, or ejection fraction \< 45% on echocardiography
* Initiation of PAH therapy (prostacyclin analogues, endothelin-1 receptor antagonists, phosphodiesterase-5 inhibitors) within three months of enrollment; the dose must be stable for at least 3 months prior to Baseline Visit
* Hormone therapy
* Hospitalized or acutely ill
* Renal failure (creatinine \> 2.0)
* Child-Pugh Class C cirrhosis
* Current or recent (\< 6 months) chronic heavy alcohol consumption
* Current use of another investigational drug (non-FDA approved) for PAH
* Enrollment in a clinical trial within one month of screening
* Age \< 18

Primary outcomes:
measure: Plasma Estradiol (E2) Level
timeFrame: Baseline, 3 months
measure: Tricuspid Annular Plane Systolic Excursion (TAPSE)
timeFrame: Baseline, 3 months
Secondary outcomes:
measure: Six Minute Walk Distance
timeFrame: Baseline, 3 months
Other outcomes:
Locations:
city: Philadelphia
country: United States
facility: University of Pennsylvania - Penn Presbyterian
state: Pennsylvania
city: Philadelphia
country: United States
facility: University of Pennsylvania - Perelman Center
state: Pennsylvania
city: Providence
country: United States
facility: Brown University - Rhode Island Hospital
state: Rhode Island
Study officials:
affiliation: University of Pennsylvania
name: Steven M Kawut, MD, MS
role: PRINCIPAL_INVESTIGATOR
References:
citation: Kawut SM, Archer-Chicko CL, DeMichele A, Fritz JS, Klinger JR, Ky B, Palevsky HI, Palmisciano AJ, Patel M, Pinder D, Propert KJ, Smith KA, Stanczyk F, Tracy R, Vaidya A, Whittenhall ME, Ventetuolo CE. Anastrozole in Pulmonary Arterial Hypertension. A Randomized, Double-Blind, Placebo-controlled Trial. Am J Respir Crit Care Med. 2017 Feb 1;195(3):360-368. doi: 10.1164/rccm.201605-1024OC.