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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
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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/NCT02657356
Registration number
NCT02657356
Ethics application status
Date submitted
13/01/2016
Date registered
15/01/2016
Date last updated
6/02/2024
Titles & IDs
Public title
Bardoxolone Methyl in Patients With Connective Tissue Disease-associated Pulmonary Arterial Hypertension - CATALYST
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Scientific title
A Study of the Efficacy and Safety of Bardoxolone Methyl in Patients With Connective Tissue Disease-associated Pulmonary Arterial Hypertension
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Secondary ID [1]
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RTA 402-C-1504
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Connective Tissue Disease-Associated Pulmonary Arterial Hypertension
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Condition category
Condition code
Respiratory
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Other respiratory disorders / diseases
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Human Genetics and Inherited Disorders
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0
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Other human genetics and inherited disorders
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Cardiovascular
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0
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Hypertension
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Skin
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Other skin conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Placebo capsules
Treatment: Drugs - Bardoxolone methyl capsules
Placebo Comparator: Placebo capsules - Placebo capsules will be administered orally once a day for 24 weeks.
Experimental: Bardoxolone methyl capsules - Each patient will receive bardoxolone methyl capsules administered orally once a day for 24 weeks. Starting dosage for each patient is 5 mg and will dose-escalate to 10 mg at Week 4, unless contraindicated clinically.
Treatment: Drugs: Placebo capsules
Treatment: Drugs: Bardoxolone methyl capsules
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Change From Baseline in Six-minute-walk Distance (6MWD) Relative to Placebo at Week 24
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Assessment method [1]
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Timepoint [1]
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Baseline through 24 weeks after participant receives the first dose
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Secondary outcome [1]
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Time to First Persistent Clinical Improvement Event
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Assessment method [1]
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At least one of the following four criteria must have been met:
Improvement by at least one WHO functional class coupled with no more than a 15% decrease from baseline in 6MWT
Increase from baseline in 6MWT by at least 10% and stability or improvement in the WHO functional class
Decrease from baseline in creatine kinase (a surrogate biomarker for muscle injury and inflammation) by at least 10% and no worsening in WHO functional class and no more than a 15% decrease from baseline in 6MWT
Improvement in estimated glomerular filtration rate eGFR =10% of baseline The persistence of the change in WHO functional class, 6MWT, eGFR, or creatine kinase must be confirmed by a subsequent assessment at least 14 days after the initial assessment, or at the next scheduled assessment. If persistent improvement is confirmed, the date of the event was considered the initial assessment of improved WHO functional class, 6MWT, eGFR, or creatine kinase.
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Timepoint [1]
0
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Baseline through the end of the study
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Eligibility
Key inclusion criteria
- BMI > 18.5 kg/m2;
- Symptomatic pulmonary hypertension WHO/NYHA FC class II and III;
- WHO Group I PAH associated with connective tissue disease;
- Had a diagnostic right heart catheterization performed and documented within 36 months
prior to Day 1 that confirmed a diagnosis of PAH according to all the following
criteria:
- Mean pulmonary artery pressure = 25 mm Hg (at rest);
- Pulmonary capillary wedge pressure (PCWP) = 15 mm Hg;
- Pulmonary vascular resistance > 240 dyn.sec/cm5 or > 3 mm Hg/liter (L)/minute;
- Has BNP level = 400 pg/mL;
- Had an average 6MWD = 150 meters on two consecutive tests performed on different days
prior to randomization, with both tests measuring within 15% of one another;
- Has been receiving no more than two (2) approved disease-specific PAH therapies. PAH
therapy must have been at a stable dose for at least 90 days prior to Day 1. No
additions or changes should be made to PAH therapies and doses should remain stable
for the duration of the study;
- Has maintained a stable dose for 30 days prior to Day 1 if receiving any of the
following therapies that may affect PAH: vasodilators (including calcium channel
blockers), digoxin, L-arginine supplementation, or oxygen supplementation. No
additions or changes should be made to therapies and doses should remain stable for
the duration of the study;
- If receiving treatment for CTD with prednisone or any other drugs, doses must remain
stable for at least 30 days prior to Day 1 and for the duration of the study Had
pulmonary function tests (PFTs) within 90 days prior to Day 1 with total lung capacity
= 65% (predicted);
- Had a ventilation-perfusion (V/Q) lung scan, spiral/helical/electron beam computed
tomography (CT), or pulmonary angiogram prior to Day 1 that shows no evidence of
thromboembolic disease (i.e., should note normal or low probability for pulmonary
embolism). If V/Q scan was abnormal (i.e., results other than normal or low
probability), then a confirmatory CT or selective pulmonary angiography must exclude
chronic thromboembolic pulmonary hypertension;
- Has adequate kidney function defined as an estimated glomerular filtration rate (eGFR)
= 45 mL/min/1.73 m2 as measured by the central lab;
- Willing and able to comply with scheduled visits, treatment plan, laboratory tests,
and other study procedures;
- Evidence of a personally signed and dated informed consent document indicating that
the patient (or a legally acceptable representative) has been informed of all
pertinent aspects of the study prior to initiation of any patient-mandated procedures
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Participation in other investigational clinical studies involving interventional
products being tested or used in a way different from the approved form or when used
for an unapproved indication within 30 days prior to Day 1;
- Initiation of an exercise program for cardio-pulmonary rehabilitation within 90 days
prior to Day 1 or planned initiation during the study;
- Stopped receiving any PAH chronic therapy within 60 days prior to Day 1;
- Received a dose of prednisone > 20 mg/day (or equivalent dose if other corticosteroid)
within 30 days prior to Day 1;
- Received intravenous (iv) or subcutaneous (sc) prostacyclin/prostacyclin analogues
within 90 days prior to Day 1;
- Received intravenous inotropes within 30 days prior to Day 1;
- Has uncontrolled systemic hypertension as evidenced by sitting systolic blood pressure
(BP) > 160 mm Hg or sitting diastolic BP > 100 mm Hg during Screening after a period
of rest;
- Has systolic BP < 90 mm Hg during Screening after a period of rest;
- Has a history of clinically significant left-sided heart disease and/or clinically
significant cardiac disease, including but not limited to any of the following:
- Congenital or acquired valvular disease if clinically significant apart from
tricuspid valvular insufficiency due to pulmonary hypertension;
- Pericardial constriction;
- Restrictive or congestive cardiomyopathy;
- Left ventricular ejection fraction < 40% per echocardiogram (ECHO) within 90 days
of Day 1;
- Symptomatic coronary artery disease within the last 3 years;
- Acutely decompensated heart failure within 30 days prior to Day 1, per investigator
assessment;
- Has more than two of the following clinical risk factors for left ventricular
diastolic dysfunction:
- Age > 65 years;
- BMI = 30 kg/m2;
- History of systemic hypertension;
- History of type 2 diabetes;
- History of atrial fibrillation;
- History of atrial septostomy within 180 days prior to Day 1;
- History of uncontrolled obstructive sleep apnea;
- Has a history of portal hypertension or chronic liver disease, including hepatitis B
and/or hepatitis C (with evidence of recent infection and/or active virus replication)
defined as mild to severe hepatic impairment (Child-Pugh Class A-C);
- Serum aminotransferase (ALT or AST) levels > 1.5X the upper limit of normal (ULN) at
Screening;
- Hemoglobin (Hgb) concentration < 8.5 g/dL at Screening;
- Diagnosis of Down syndrome;
- History of malignancy within 5 years prior to screening, with the exception of
localized skin or cervical carcinomas;
- Untreated or uncontrolled active bacterial, fungal, or viral infection;
- Known or suspected active drug or alcohol abuse, per investigator judgment;
- Use of Herbalife supplements within 14 days prior to Day 1;
- Major surgery within 30 days prior to Day 1 or planned to occur during the course of
the study;
- Unwilling to practice acceptable methods of birth control (both males who have
partners of childbearing potential and females of childbearing potential) during
screening, while taking study drug, and for at least 30 days after the last dose of
study drug is ingested;
- Use of inhaled nitric oxide within 7 days prior to Screening and Day 1 visits,
excluding acute vasodilator testing during diagnostic cardiac catheterization;
- Women who are pregnant or breastfeeding;
- Any disability or impairment that would prohibit performance of the 6MWT;
- Any abnormal laboratory level that, in the opinion of the investigator, would put the
patient at risk by trial enrollment;
- Patient is, in the opinion of the investigator, unable to comply with the requirements
of the study protocol or is unsuitable for the study for any reason;
- Known hypersensitivity to any component of the study drug;
- Unable to communicate or cooperate with the investigator because of language problems,
poor mental development, or impaired cerebral function.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Terminated
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
4/10/2016
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
7/05/2020
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Sample size
Target
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Accrual to date
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Final
202
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,TAS
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Recruitment hospital [1]
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Royal Prince Alfred Hospital - Camperdown
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St Vincent's Hospital Sydney - Darlinghurst
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John Hunter Hospital - New Lambton
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Princess Alexandra Hospital - Brisbane
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Royal Hobart Hospital - Hobart
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2050 - Camperdown
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2010 - Darlinghurst
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2305 - New Lambton
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4102 - Brisbane
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7000 - Hobart
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Reata, a wholly owned subsidiary of Biogen
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
This study assesses the safety and efficacy of bardoxolone methyl relative to placebo in
patients with connective tissue disease-associated pulmonary arterial hypertension to
determine the recommended dose range and evaluate the change from baseline in 6-minute walk
distance (6MWD) following 24 weeks of study participation.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT02657356
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT02657356
Download to PDF