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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT04273945




Registration number
NCT04273945
Ethics application status
Date submitted
31/01/2020
Date registered
18/02/2020
Date last updated
22/05/2024

Titles & IDs
Public title
Outcome Study Assessing a 75 Milligrams (mg) Dose of Macitentan in Patients With Pulmonary Arterial Hypertension
Scientific title
A Phase 3, Prospective, Multicenter, Double-blind, Double-dummy, Randomized, Active-controlled, Parallel-group, Group-sequential, Adaptive, Event-driven Study to Compare Efficacy, Safety, and Tolerability of Macitentan 75 mg Versus Macitentan 10 mg in Patients With Pulmonary Arterial Hypertension, Followed by an Open-label Treatment Period With Macitentan 75 mg
Secondary ID [1] 0 0
2019-002533-11
Secondary ID [2] 0 0
CR108740
Universal Trial Number (UTN)
Trial acronym
UNISUS
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Pulmonary Arterial Hypertension 0 0
Condition category
Condition code
Respiratory 0 0 0 0
Other respiratory disorders / diseases
Human Genetics and Inherited Disorders 0 0 0 0
Other human genetics and inherited disorders
Cardiovascular 0 0 0 0
Hypertension

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Macitentan 10 mg
Treatment: Drugs - Macitentan 37.5 mg
Treatment: Drugs - Macitentan 75 mg
Treatment: Drugs - Placebo

Active Comparator: Macitentan 10 milligrams (mg) + Placebo - Run-in period:Participants who are either endothelin receptor antagonist (ERA)-naïve or who are receiving daily dose of macitentan or ambrisentan less (<) 10 milligrams (mg), or daily dose of bosentan <250 mg, will enter 4-week open-label run-in period with macitentan 10 mg prior to randomization. ERA-pre-treated participants will bypass run-in period and will be randomized to either macitentan 75 mg or macitentan 10 mg directly.Double-blind Treatment (DBT) Period:Participants will receive macitentan 10 mg orally up to End of DBT.To maintain blind, participants will receive macitentan 37.5 mg-matching placebo for 4 weeks and macitentan 75 mg-matching placebo thereafter up to DBT.Treatment Extension Period:After EDBT, participants will receive macitentan 37.5 mg once a day (qd) orally for 4 weeks, prior to receiving open-label macitentan 75 mg qd orally for 2 years. To maintain blind, participants will receive macitentan 75 mg-matching placebo during 4-week uptitration.

Experimental: Macitentan 75 mg + Placebo - Run-in period:Participants who are either ERA-naive or who are receiving a daily dose of macitentan or ambrisentan <10 mg, or a daily dose of bosentan <250 mg, will enter 4-week open-label run-in period with macitentan 10 mg prior to randomization. ERA-pre-treated patients will bypass the run-in period and will be randomized to either macitentan 75 mg or macitentan 10 mg directly.DBT Period: participants will receive macitentan 37.5 mg orally for 4 weeks and macitentan 75 mg thereafter up to End of DBT. To maintain the blind, participants will receive macitentan 10 mg-matching placebo up to End of DBT.Treatment Extension Period: After EDBT, participants will continue to receive macitentan 75 mg orally for 2 years. To maintain the blind, participants will receive macitentan 37.5 mg-matching placebo during the 4-week up-titration period.


Treatment: Drugs: Macitentan 10 mg
Participants will receive macitentan 10 mg film-coated tablets orally.

Treatment: Drugs: Macitentan 37.5 mg
Participants will receive macitentan 37.5 mg film-coated tablets orally.

Treatment: Drugs: Macitentan 75 mg
Participants will receive macitentan 75 mg film-coated tablets orally.

Treatment: Drugs: Placebo
Participants will receive matching placebo film-coated tablets orally.
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Double-blind Treatment Period: Time to First Clinical Events Committee (CEC)-adjudicated Morbidity or Mortality (M/M) Events
Timepoint [1] 0 0
Up to 4 years
Secondary outcome [1] 0 0
Double-blind Treatment Period: Change From Baseline to Week 24 in 6MWD
Timepoint [1] 0 0
Baseline up to Week 24
Secondary outcome [2] 0 0
Double-blind Treatment Period: Number of Participants with CEC-adjudicated Death due to PAH and/or Hospitalizations for PAH (First and Recurrent) Events on-treatment
Timepoint [2] 0 0
Up to 4 years
Secondary outcome [3] 0 0
Double-blind Treatment Period: Change From Baseline to Week 24 in PAH Symptoms Based on PAH-SYMPACT Questionnaire- Cardiopulmonary Symptom Domain Score
Timepoint [3] 0 0
Baseline up to Week 24
Secondary outcome [4] 0 0
Double-blind Treatment Period: Change From Baseline to Week 24 in PAH Symptoms Based on PAH-SYMPACT Questionnaire- Cardiovascular Symptom Domain Score
Timepoint [4] 0 0
Baseline up to Week 24
Secondary outcome [5] 0 0
Double-blind Treatment Period: Time to Death Occurring Between Randomization and End of Double-blind Treatment (EDBT)
Timepoint [5] 0 0
Up to 4 years
Secondary outcome [6] 0 0
Treatment Extension Period: Time to Death Occurring Between Randomization and End of Study (EOS)
Timepoint [6] 0 0
Up to 6 years

Eligibility
Key inclusion criteria
- Target population: greater than or equal to (>=) 18 (or the legal age of consent in
the jurisdiction in which the study is taking place) years of age

- Target population: Symptomatic Pulmonary Arterial Hypertension (PAH) in World Health
Organization Functional Class (WHO FC) II, III, or IV

- Target population: PAH subtype falling in one of the below classifications:
Idiopathic; Heritable; Drug- or toxin-induced; Related to: Connective tissue disease,
HIV infection, Portal hypertension, and Congenital heart disease with
small/coincidental cardiac defect with systemic-to-pulmonary shunt (for example atrial
septal defect, ventricular septal defect, patent ductus arteriosus, atrioventricular
septal defect) which does not account for the elevated pulmonary vascular resistance
(PVR) or persistent PAH documented by an Right heart catheterization (RHC) >= 1 year
after simple systemic-to pulmonary shunt repair

- PAH diagnosis confirmed by hemodynamic evaluation at rest at any time prior to
screening: Mean pulmonary artery pressure (mPAP) greater than (>) 20 millimeters of
mercury (mm Hg), and; Pulmonary artery wedge pressure (PAWP) or left ventricular end
diastolic pressure (LVEDP) less than or equal to (<=) 15 mm Hg, and PVR >= 3 Wood
Units (that is, >= 240 dyn*sec/cm^5)

- Able to perform the 6-minute walking test (6MWT) with a minimum distance of 50 meters
(m) and maximum distance of 440m at screening. Participants able to walk more than
440m at screening are eligible if they are in WHO FC III or IV and n-terminal
prohormone of brain natriuretic peptide or n-terminal pro B-type natriuretic peptide
(NT-proBNP) level is >=300 nanograms per liter (ng/L) at screening, based on central
laboratory results
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
- Known presence of three or more of the following risk factors for heart failure with
preserved ejection fraction at screening, based on records that confirm documented
medical history: Body mass index (BMI) > 30 kilograms per meter square (kg/m^2),
Diabetes mellitus of any type, Essential hypertension (even if well controlled);
Coronary artery disease, that is, any of the following: history of stable angina, or
known more than 50 percent (%) stenosis in a coronary artery, or history of myocardial
infarction, or history of or planned coronary artery bypass grafting and/or coronary
artery stenting

- Presence of moderate or severe obstructive lung disease (forced expiratory volume in 1
second [FEV1] / forced vital capacity [FVC] < 70%; and FEV1 < 60% of predicted after
bronchodilator administration) ) in participants with a known or suspected history of
significant lung disease as documented by a spirometry test performed within 1 year
prior to screening

- Known moderate to severe hepatic impairment, defined as Child-Pugh Class B or C, based
on records that confirm documented medical history

- Serum aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) >
1.5*upper limit of normal (ULN) at screening

- Hemoglobin < 100 gram per liter (g/L) (< 10 gram per deciliter [g/dL]) at screening

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s

The people assessing the outcomes
The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
30/06/2020
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
20/02/2029
Actual
Sample size
Target
900
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
Flinders Medical Centre - Bedford Park
Recruitment hospital [2] 0 0
Royal Prince Alfred Hospital - Camperdown
Recruitment hospital [3] 0 0
The Prince Charles Hospital - Chermside
Recruitment hospital [4] 0 0
St Vincent's hospital - Darlinghurst
Recruitment hospital [5] 0 0
Royal Hobart Hospital - Hobart
Recruitment hospital [6] 0 0
Fiona Stanley Hospital - Murdoch
Recruitment hospital [7] 0 0
Westmead Hospital - Westmead
Recruitment postcode(s) [1] 0 0
5042 - Bedford Park
Recruitment postcode(s) [2] 0 0
2050 - Camperdown
Recruitment postcode(s) [3] 0 0
4032 - Chermside
Recruitment postcode(s) [4] 0 0
2010 - Darlinghurst
Recruitment postcode(s) [5] 0 0
7000 - Hobart
Recruitment postcode(s) [6] 0 0
6150 - Murdoch
Recruitment postcode(s) [7] 0 0
2145 - Westmead
Recruitment outside Australia
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Adana
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Antalya
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Bursa
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State/province [185] 0 0
Denizli
Country [186] 0 0
Turkey
State/province [186] 0 0
Istanbul
Country [187] 0 0
Turkey
State/province [187] 0 0
Izmir
Country [188] 0 0
Turkey
State/province [188] 0 0
Kartal Istanbul
Country [189] 0 0
Turkey
State/province [189] 0 0
Mersin
Country [190] 0 0
Ukraine
State/province [190] 0 0
Cherkassy
Country [191] 0 0
Ukraine
State/province [191] 0 0
Cherkasy
Country [192] 0 0
Ukraine
State/province [192] 0 0
Dnipro
Country [193] 0 0
Ukraine
State/province [193] 0 0
Kharkiv
Country [194] 0 0
Ukraine
State/province [194] 0 0
Kyiv
Country [195] 0 0
Ukraine
State/province [195] 0 0
Lviv
Country [196] 0 0
Ukraine
State/province [196] 0 0
Ternopil
Country [197] 0 0
United Kingdom
State/province [197] 0 0
London
Country [198] 0 0
United Kingdom
State/province [198] 0 0
Newcastle Upon Tyne
Country [199] 0 0
United Kingdom
State/province [199] 0 0
Sheffield
Country [200] 0 0
Vietnam
State/province [200] 0 0
Hanoi
Country [201] 0 0
Vietnam
State/province [201] 0 0
Ho Chi Minh

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Actelion
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
The purpose of this study is to demonstrate superiority of macitentan 75 milligrams (mg) in
prolonging the time to the first clinical events committee (CEC)-adjudicated morbidity or
mortality (M/M) event in participants with symptomatic pulmonary arterial hypertension (PAH)
compared to macitentan 10 mg.
Trial website
https://clinicaltrials.gov/ct2/show/NCT04273945
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Actelion Clinical Trials
Address 0 0
Actelion
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Study Contact
Address 0 0
Country 0 0
Phone 0 0
844-434-4210
Fax 0 0
Email 0 0
[email protected]
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT04273945