Pulmonary Hypertension
Conditions
Keywords
pulmonary hypertension, PAH, Remodulin, treprostinil, Quality of Life, Rapid Switch
Brief summary
The purpose of this 8-week study is to compare the effects of switching from therapy with epoprostenol or Flolan to IV Remodulin. This study will also assess the effect that changing to Remodulin will have on patient satisfaction with their treatment and impact on quality of life.
Detailed description
Pulmonary arterial hypertension (PAH), which is defined as an elevation in pulmonary arterial pressure and pulmonary vascular resistance, is a severe hemodynamic abnormality common to a variety of diseases and syndromes. Elevation in pulmonary arterial pressure causes an increase in right ventricular afterload, impairing right ventricular function and ultimately leading to inactivity and death. The goal of PAH treatment is to lengthen survival time, to ameliorate symptoms of PAH and to improve health related quality of life (HRQOL). Remodulin® (treprostinil sodium), a stable analogue of prostacyclin, possesses potent pulmonary and systemic vasodilatory and platelet anti-aggregatory actions in vitro and in vivo. Recently, Remodulin received FDA approval for intravenous therapy based upon bioequivalence of the IV and SC routes of administration. Remodulin is more chemically stable than epoprostenol and may offer potential safety and convenience advantages compared to intravenous epoprostenol that may impact Health Related Quality of Life (HRQOL) and/or patient satisfaction. Unlike epoprostenol, Remodulin does not need to be mixed daily and is stable at room temperature eliminating the need for ice packs. Furthermore, since Remodulin remains in the body longer than epoprostenol (4 hrs instead of less than 5 minutes) there is less risk of cardiovascular collapse from a sudden interruption of infusion, such as a line clog. In an open-label study in Europe, patients who were using a type of portable medication pump called the CADD Legacy pump were rapidly switched from Flolan to Remodulin with no serious side effects. This study will examine effects of switching from therapy with epoprostenol or Flolan to IV Remodulin and compare changes in HRQOL and treatment satisfaction before and after rapid switch from epoprostenol to Remodulin in patients with pulmonary hypertension using the CADD legacy pump. Participation in this study will last approximately 10 weeks. Study procedures include routine blood tests, medical history, physical exams, disease evaluation, exercise tests and patient questionnaires. Participants will have 4 visits during the study and will spend at least 1 night in the hospital.
Interventions
rapid switch from intravenous epoprostinol to intravenous remodulin on the CADD ambulatory pump
Sponsors
United Therapeutics
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Age 18 to 70 years * Diagnosis of Idiopathic or Familial Pulmonary Arterial Hypertension (PAH)or PAH associated with a collagen vascular disease or PAH associated with congenital systemic-to-pulmonary shunt repaired greater than 5 years prior to study entry or PAH associated with portal hypertension with mild or moderate hepatic dysfunction (Grade of A or B on the Child-Pugh Classification Scale)or PAH associated with drug or toxins or CTEPH * WHO Class II-III * Currently receiving intravenous epoprostenol therapy for at least three months and a stable dose for at least one month. * Have central intravenous catheter * Optimally treated with conventional pulmonary hypertension therapy and clinically stable for at least one month. * Mentally and physically capable of learning to administer Remodulin using an intravenous infusion pump.
Exclusion criteria
* Nursing or pregnant woman * Have any other type of PAH due to conditions other than noted in the above inclusion criteria, including but not limited to PAH related to thrombotic or embolic disease * Have any other disease that is associated with pulmonary hypertension (e.g. sickle cell anemia, schistosomiasis) * Changes to chronic PAH therapy (i.e., new therapy added within last 30 days\[including but not limited to oxygen, a different category of vasodilator, a diuretic, digoxin, bosentan, sildenafil\] or PAH medication discontinued within 7 days of study entry. * Received any prostacyclin or prostacyclin analog except epoprostenol in the past 3 months. * Central venous line infection within the past 30 days. * Previous documented evidence of significant parenchymal lung disease * Evidence or history of left-sided heart disease * Musculoskeletal disorder or any other disease, which is thought to limit ambulation, or be connected to a machine that is not portable * Uncontrolled hypertension, chronic renal insufficiency, or active infection. * Use of investigational drug within past 30 days.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in the Distance Transversed During the 6 Minute Walk Test From Baseline to Week 8. | Baseline and Week 8 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in World Health Organization (WHO) Functional Classification of PAH From Baseline to Week 8 | Baseline and Week 8 | Class I: Patients with pulmonary hypertension but without resulting limitation of physical activity. Ordinary physical activity does not cause undue dyspnea or fatigue, chest pain, or near syncope. Class II: Patients with pulmonary hypertension resulting in slight limitation of physical activity. These patients are comfortable at rest, but ordinary physical activity causes undue dyspnea or fatigue, chest pain or near syncope. Class III: Patients with pulmonary hypertension resulting in marked limitation of physical activity. They are comfortable at rest. Ordinary activity causes undue dyspnea or fatigue, chest pain, or near syncope. Class IV: Patients with pulmonary hypertension with inability to carry out any physical activity without symptoms. These patients manifest signs of right heart failure. Dyspnea and/or fatigue may be present even at rest. Discomfort is increased by any physical activity. |
| Change in Symptoms of Dyspnea From Baseline to Week 8 | Baseline and Week 8 | The presence or absence of dyspnea was documented. If present, the intensity of dyspnea was rated mild, moderate, or severe. |
| Change in Symptoms of Edema From Baseline to Week 8 | Baseline to Week 8 | The presence or absence of edema was documented. If present, the intensity of edema was rated mild, moderate, or severe. |
| Change in Symptoms of Orthopnea From Baseline to Week 8 | Baseline and Week 8 | The presence or absence of orthopnea was documented. If present, the intensity of orthopnea was rated mild, moderate, or severe. |
| Change in Symptoms of Dizziness From Baseline to Week 8 | Baseline and Week 8 | The presence or absence of dizziness was documented. If present, the intensity of dizziness was rated mild, moderate, or severe. |
| Change in Symptoms of Fatigue From Baseline to Week 8 | Baseline and Week 8 | The presence or absence of fatigue was documented. If present, the intensity of fatigue was rated mild, moderate, or severe. |
| Change in Symptoms of Syncope From Baseline to Week 8 | Baseline and Week 8 | The presence or absence of syncope was documented. If present, the intensity of syncope was rated mild, moderate, or severe. |
| Change in Symptoms of Chest Pain From Baseline to Week 8 | Baseline and Week 8 | The presence or absence of chest pain was documented. If present, the intensity of chest pain was rated mild, moderate, or severe. |
| Change in Effectiveness Score on Treatment Satisfaction Scale From Baseline to Week 8 | Baseline and Week 8 | The Treatment Satisfaction Questionnaire for Medication (TSQM) is a validated instrument that measures four major dimensions of patient satisfaction with medications: effectiveness, side effects, convenience, and global satisfaction. TSQM Scale scores are computed by adding the items loading on each factor. The lowest possible score is subtracted from this composite score and divided by the greatest possible score minus the lowest possible score. This provided a transformed score between 0 and 1 that should be multiplied by 100 (scale 0-100). A low score indicates low satisfaction and a high score indicates high satisfaction with treatment. |
| Change in Side-Effects Score on Treatment Satisfaction Scale From Baseline to Week 8 | Baseline and Week 8 | The Treatment Satisfaction Questionnaire for Medication (TSQM) is a validated instrument that measures four major dimensions of patient satisfaction with medications: effectiveness, side effects, convenience, and global satisfaction. TSQM Scale scores are computed by adding the items loading on each factor. The lowest possible score is subtracted from this composite score and divided by the greatest possible score minus the lowest possible score. This provided a transformed score between 0 and 1 that should be multiplied by 100 (scale 0-100). A low score indicates low satisfaction and a high score indicates high satisfaction with treatment. |
| Change in Patient Impression of Change in Symptoms of PAH From Baseline to Week 8 | Baseline and Week 8 | Subjects were asked to compare their symptoms of PAH as compared to 8 weeks prior and rate as much better, somewhat better, about the same, somewhat worse, or much worse. |
| Change in Borg Dyspnea Score Immediately After Six Minute Walk Test From Baseline to Week 8 | Baseline and Week 8 | The Borg dyspnea score is a 10-point scale rating the maximum level of dyspnea experienced during the 6-minute walk test. The Borg dyspnea score was assessed immediately following the 6-minute walk test. Scores ranged from 0 (for no shortness of breath) to 10 (for greatest shortness of breath ever experienced). |
| Change in Global Satisfaction Score on Treatment Satisfaction Scale From Baseline to Week 8 | Baseline and Week 8 | The Treatment Satisfaction Questionnaire for Medication (TSQM) is a validated instrument that measures four major dimensions of patient satisfaction with medications: effectiveness, side effects, convenience, and global satisfaction. TSQM Scale scores are computed by adding the items loading on each factor. The lowest possible score is subtracted from this composite score and divided by the greatest possible score minus the lowest possible score. This provided a transformed score between 0 and 1 that should be multiplied by 100 (scale 0-100). A low score indicates low satisfaction and a high score indicates high satisfaction with treatment. |
| Change in Total Score on Quality of Life Questionnaire From Baseline to Week 8 | Baseline and Week 8 | The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is a health related quality of life instrument specific to PAH. The total score can range from 0 -75; the higher the score, the worse the outcome. |
| Change in Patient Impression of Change on Time Spent Dealing With Therapy From Baseline to Week 8 | Baseline and Week 8 | Subjects were asked to compare their previous experience with Flolan and rate how much time was spent dealing with intravenous Remodulin therapy as much less, somewhat less, about the same, somewhat more, or much more. |
| Change in Patient Impression of Change of Satisfaction With Therapy From Baseline to Week 8 | Baseline and Week 8 | Subjects were asked to compare their previous experience with Flolan and rate satisfaction with intravenous Remodulin therapy over the past two weeks as much more satisfied, more satisfied, about the same, less satisfied, or much less satisfied. |
| Change in Total Weekly Time Spent to Gather/Set-up Materials Associated With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Baseline and Week 8 | — |
| Change in Total Weekly Time Spent to Connect Drug With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Baseline and Week 8 | — |
| Change in Total Weekly Time Spent to Change Dressing With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Baseline and Week 8 | — |
| Change in Total Weekly Time Spent to Prepare Drug With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Baseline and Week 8 | — |
| Change in Total Number of Times Daily Required to Disconnect Infusion Pump With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Baseline and Week 8 | — |
| Change in Total Number of Times Daily Required to Check Infusion Pump With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Baseline and Week 8 | — |
| Change in Total Number of Times Daily Infusion Pump Alarms With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Baseline and Week 8 | — |
| Change in Convenience Score on Treatment Satisfaction Scale From Baseline to Week 8 | Baseline and Week 8 | The Treatment Satisfaction Questionnaire for Medication (TSQM) is a validated instrument that measures four major dimensions of patient satisfaction with medications: effectiveness, side effects, convenience, and global satisfaction. TSQM Scale scores are computed by adding the items loading on each factor. The lowest possible score is subtracted from this composite score and divided by the greatest possible score minus the lowest possible score. This provided a transformed score between 0 and 1 that should be multiplied by 100 (scale 0-100). A low score indicates low satisfaction and a high score indicates high satisfaction with treatment. |
Countries
United States
Participant flow
Recruitment details
Subject participated in this study between July 2007 and January 2008.
Pre-assignment details
All subjects were required to be receiving continuous intravenous epoprostenol therapy for at least three months and at a stable dose for at least thirty days prior to enrollment in this study.
Participants by arm
| Arm | Count |
|---|---|
| Treprostinil Sodium All subjects received active treatment with treprostinil sodium. | 10 |
| Total | 10 |
Baseline characteristics
| Characteristic | Treprostinil Sodium |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 2 Participants |
| Age, Categorical Between 18 and 65 years | 8 Participants |
| Epoprostenol dose | 27.15 ng/kg/min |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 10 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| PAH Etiology Connective Tissue Disease (CTD) | 2 participants |
| PAH Etiology Idiopathic PAH | 7 participants |
| PAH Etiology Other | 1 participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 3 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 6 Participants |
| Region of Enrollment United States | 10 participants |
| Sex: Female, Male Female | 8 Participants |
| Sex: Female, Male Male | 2 Participants |
| Six minute walk distance | 447.7 meters |
| World Health Organization (WHO) Functional Classification for PAH Class II | 6 participants |
| World Health Organization (WHO) Functional Classification for PAH Class III | 4 participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 9 / 10 |
| serious Total, serious adverse events | 2 / 10 |
Outcome results
Primary
Change in the Distance Transversed During the 6 Minute Walk Test From Baseline to Week 8.
Time frame: Baseline and Week 8
Population: As this was a small open label study, the statistics applied to the results were descriptive. For all efficacy endpoints, data obtained from study assessments during the treatment phase were compared to Baseline.~assessments
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treprostinil Sodium | Change in the Distance Transversed During the 6 Minute Walk Test From Baseline to Week 8. | -2.2 meters | Standard Deviation 34.8 |
Comparison: Change between Baseline and Week 8p-value: 1Wilcoxon signed rank test
Secondary
Change in Borg Dyspnea Score Immediately After Six Minute Walk Test From Baseline to Week 8
The Borg dyspnea score is a 10-point scale rating the maximum level of dyspnea experienced during the 6-minute walk test. The Borg dyspnea score was assessed immediately following the 6-minute walk test. Scores ranged from 0 (for no shortness of breath) to 10 (for greatest shortness of breath ever experienced).
Time frame: Baseline and Week 8
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treprostinil Sodium | Change in Borg Dyspnea Score Immediately After Six Minute Walk Test From Baseline to Week 8 | 1.56 units on a scale | Standard Deviation 0.98 |
Comparison: Change between Baseline and Week 8p-value: 0.008Wilcoxon signed rank test
Secondary
Change in Convenience Score on Treatment Satisfaction Scale From Baseline to Week 8
The Treatment Satisfaction Questionnaire for Medication (TSQM) is a validated instrument that measures four major dimensions of patient satisfaction with medications: effectiveness, side effects, convenience, and global satisfaction. TSQM Scale scores are computed by adding the items loading on each factor. The lowest possible score is subtracted from this composite score and divided by the greatest possible score minus the lowest possible score. This provided a transformed score between 0 and 1 that should be multiplied by 100 (scale 0-100). A low score indicates low satisfaction and a high score indicates high satisfaction with treatment.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Convenience Score on Treatment Satisfaction Scale From Baseline to Week 8 | Convenience Score at Baseline | 59.9 units on a scale | Standard Deviation 14.4 |
| Treprostinil Sodium | Change in Convenience Score on Treatment Satisfaction Scale From Baseline to Week 8 | Convenience Score at Week 8 | 90.7 units on a scale | Standard Deviation 10.8 |
Comparison: Change between Baseline and Week 8p-value: 0.004Wilcoxon signed rank test
Secondary
Change in Effectiveness Score on Treatment Satisfaction Scale From Baseline to Week 8
The Treatment Satisfaction Questionnaire for Medication (TSQM) is a validated instrument that measures four major dimensions of patient satisfaction with medications: effectiveness, side effects, convenience, and global satisfaction. TSQM Scale scores are computed by adding the items loading on each factor. The lowest possible score is subtracted from this composite score and divided by the greatest possible score minus the lowest possible score. This provided a transformed score between 0 and 1 that should be multiplied by 100 (scale 0-100). A low score indicates low satisfaction and a high score indicates high satisfaction with treatment.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Effectiveness Score on Treatment Satisfaction Scale From Baseline to Week 8 | Effectiveness Score at Baseline | 71.6 units on a scale | Standard Deviation 29.2 |
| Treprostinil Sodium | Change in Effectiveness Score on Treatment Satisfaction Scale From Baseline to Week 8 | Effectiveness Score at Week 8 | 82.7 units on a scale | Standard Deviation 23.1 |
Comparison: Change between Baseline and Week 8p-value: 0.031Wilcoxon signed rank test
Secondary
Change in Global Satisfaction Score on Treatment Satisfaction Scale From Baseline to Week 8
The Treatment Satisfaction Questionnaire for Medication (TSQM) is a validated instrument that measures four major dimensions of patient satisfaction with medications: effectiveness, side effects, convenience, and global satisfaction. TSQM Scale scores are computed by adding the items loading on each factor. The lowest possible score is subtracted from this composite score and divided by the greatest possible score minus the lowest possible score. This provided a transformed score between 0 and 1 that should be multiplied by 100 (scale 0-100). A low score indicates low satisfaction and a high score indicates high satisfaction with treatment.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Global Satisfaction Score on Treatment Satisfaction Scale From Baseline to Week 8 | Global Satisfaction Score at Baseline | 84.1 units on a scale | Standard Deviation 15.1 |
| Treprostinil Sodium | Change in Global Satisfaction Score on Treatment Satisfaction Scale From Baseline to Week 8 | Global Satisfaction Score at Week 8 | 92.1 units on a scale | Standard Deviation 14 |
Comparison: Change between Baseline and Week 8p-value: 0.063Wilcoxon signed rank test
Secondary
Change in Patient Impression of Change in Symptoms of PAH From Baseline to Week 8
Subjects were asked to compare their symptoms of PAH as compared to 8 weeks prior and rate as much better, somewhat better, about the same, somewhat worse, or much worse.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in Patient Impression of Change in Symptoms of PAH From Baseline to Week 8 | Much better | 5 participants |
| Treprostinil Sodium | Change in Patient Impression of Change in Symptoms of PAH From Baseline to Week 8 | Somewhat better | 1 participants |
| Treprostinil Sodium | Change in Patient Impression of Change in Symptoms of PAH From Baseline to Week 8 | About the same | 3 participants |
| Treprostinil Sodium | Change in Patient Impression of Change in Symptoms of PAH From Baseline to Week 8 | Somewhat worse | 0 participants |
| Treprostinil Sodium | Change in Patient Impression of Change in Symptoms of PAH From Baseline to Week 8 | Much worse | 0 participants |
Secondary
Change in Patient Impression of Change of Satisfaction With Therapy From Baseline to Week 8
Subjects were asked to compare their previous experience with Flolan and rate satisfaction with intravenous Remodulin therapy over the past two weeks as much more satisfied, more satisfied, about the same, less satisfied, or much less satisfied.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in Patient Impression of Change of Satisfaction With Therapy From Baseline to Week 8 | Much more satisfied | 7 participants |
| Treprostinil Sodium | Change in Patient Impression of Change of Satisfaction With Therapy From Baseline to Week 8 | More satisfied | 2 participants |
| Treprostinil Sodium | Change in Patient Impression of Change of Satisfaction With Therapy From Baseline to Week 8 | About the same | 0 participants |
| Treprostinil Sodium | Change in Patient Impression of Change of Satisfaction With Therapy From Baseline to Week 8 | Less satisfied | 0 participants |
| Treprostinil Sodium | Change in Patient Impression of Change of Satisfaction With Therapy From Baseline to Week 8 | Much less satisfied | 0 participants |
Secondary
Change in Patient Impression of Change on Time Spent Dealing With Therapy From Baseline to Week 8
Subjects were asked to compare their previous experience with Flolan and rate how much time was spent dealing with intravenous Remodulin therapy as much less, somewhat less, about the same, somewhat more, or much more.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in Patient Impression of Change on Time Spent Dealing With Therapy From Baseline to Week 8 | Much less | 8 participants |
| Treprostinil Sodium | Change in Patient Impression of Change on Time Spent Dealing With Therapy From Baseline to Week 8 | Somewhat Less | 0 participants |
| Treprostinil Sodium | Change in Patient Impression of Change on Time Spent Dealing With Therapy From Baseline to Week 8 | About the same | 1 participants |
| Treprostinil Sodium | Change in Patient Impression of Change on Time Spent Dealing With Therapy From Baseline to Week 8 | Somewhat more | 0 participants |
| Treprostinil Sodium | Change in Patient Impression of Change on Time Spent Dealing With Therapy From Baseline to Week 8 | Much more | 0 participants |
Secondary
Change in Side-Effects Score on Treatment Satisfaction Scale From Baseline to Week 8
The Treatment Satisfaction Questionnaire for Medication (TSQM) is a validated instrument that measures four major dimensions of patient satisfaction with medications: effectiveness, side effects, convenience, and global satisfaction. TSQM Scale scores are computed by adding the items loading on each factor. The lowest possible score is subtracted from this composite score and divided by the greatest possible score minus the lowest possible score. This provided a transformed score between 0 and 1 that should be multiplied by 100 (scale 0-100). A low score indicates low satisfaction and a high score indicates high satisfaction with treatment.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Side-Effects Score on Treatment Satisfaction Scale From Baseline to Week 8 | Side Effects Score at Baseline | 71.5 units on a scale | Standard Deviation 14.4 |
| Treprostinil Sodium | Change in Side-Effects Score on Treatment Satisfaction Scale From Baseline to Week 8 | Side Effects Score at Week 8 | 84.7 units on a scale | Standard Deviation 12.1 |
Comparison: Change between Baseline and Week 8p-value: 0.031Wilcoxon signed rank test
Secondary
Change in Symptoms of Chest Pain From Baseline to Week 8
The presence or absence of chest pain was documented. If present, the intensity of chest pain was rated mild, moderate, or severe.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in Symptoms of Chest Pain From Baseline to Week 8 | No Change | 89 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Chest Pain From Baseline to Week 8 | Worsened | 11 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Chest Pain From Baseline to Week 8 | Improved | 0 percentage of participants |
Comparison: Change between Baseline and Week 8p-value: 1Wilcoxon signed rank test
Secondary
Change in Symptoms of Dizziness From Baseline to Week 8
The presence or absence of dizziness was documented. If present, the intensity of dizziness was rated mild, moderate, or severe.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in Symptoms of Dizziness From Baseline to Week 8 | Improved | 11 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Dizziness From Baseline to Week 8 | No Change | 89 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Dizziness From Baseline to Week 8 | Worsened | 0 percentage of participants |
Comparison: Change between Baseline and Week 8p-value: 1Wilcoxon signed rank test
Secondary
Change in Symptoms of Dyspnea From Baseline to Week 8
The presence or absence of dyspnea was documented. If present, the intensity of dyspnea was rated mild, moderate, or severe.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in Symptoms of Dyspnea From Baseline to Week 8 | Improved | 22 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Dyspnea From Baseline to Week 8 | No Change | 33 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Dyspnea From Baseline to Week 8 | Worsened | 44 percentage of participants |
Comparison: Change between Baseline and Week 8p-value: 0.531Wilcoxon signed rank test
Secondary
Change in Symptoms of Edema From Baseline to Week 8
The presence or absence of edema was documented. If present, the intensity of edema was rated mild, moderate, or severe.
Time frame: Baseline to Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in Symptoms of Edema From Baseline to Week 8 | Worsened | 22 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Edema From Baseline to Week 8 | Improved | 22 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Edema From Baseline to Week 8 | No Change | 56 percentage of participants |
Comparison: Change between Baseline and Week 8p-value: 1Wilcoxon signed rank test
Secondary
Change in Symptoms of Fatigue From Baseline to Week 8
The presence or absence of fatigue was documented. If present, the intensity of fatigue was rated mild, moderate, or severe.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in Symptoms of Fatigue From Baseline to Week 8 | Improved | 22 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Fatigue From Baseline to Week 8 | No Change | 67 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Fatigue From Baseline to Week 8 | Worsened | 11 percentage of participants |
Comparison: Change from Baseline to Week 8p-value: 1Wilcoxon signed rank test
Secondary
Change in Symptoms of Orthopnea From Baseline to Week 8
The presence or absence of orthopnea was documented. If present, the intensity of orthopnea was rated mild, moderate, or severe.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in Symptoms of Orthopnea From Baseline to Week 8 | Improved | 22 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Orthopnea From Baseline to Week 8 | No Change | 78 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Orthopnea From Baseline to Week 8 | Worsened | 0 percentage of participants |
Comparison: Change between Baseline and Week 8p-value: 0.5Wilcoxon signed rank test
Secondary
Change in Symptoms of Syncope From Baseline to Week 8
The presence or absence of syncope was documented. If present, the intensity of syncope was rated mild, moderate, or severe.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in Symptoms of Syncope From Baseline to Week 8 | Improved | 0 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Syncope From Baseline to Week 8 | No Change | 100 percentage of participants |
| Treprostinil Sodium | Change in Symptoms of Syncope From Baseline to Week 8 | Worsened | 0 percentage of participants |
Comparison: Change between Baseline and Week 8p-value: 0Wilcoxon signed rank test
Secondary
Change in Total Number of Times Daily Infusion Pump Alarms With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Total Number of Times Daily Infusion Pump Alarms With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Daily alarms at Baseline (epoprostenol) | 2.4 number of times per day | Standard Deviation 3.3 |
| Treprostinil Sodium | Change in Total Number of Times Daily Infusion Pump Alarms With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Daily alarms at Week 8 (Remodulin) | 0.8 number of times per day | Standard Deviation 1.1 |
Secondary
Change in Total Number of Times Daily Required to Check Infusion Pump With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Total Number of Times Daily Required to Check Infusion Pump With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Check pump at Baseline (epoprostenol) | 19.2 number of times per day | Standard Deviation 11.5 |
| Treprostinil Sodium | Change in Total Number of Times Daily Required to Check Infusion Pump With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Check pump at Week 8 (Remodulin) | 12.2 number of times per day | Standard Deviation 8.9 |
Secondary
Change in Total Number of Times Daily Required to Disconnect Infusion Pump With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Total Number of Times Daily Required to Disconnect Infusion Pump With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Disconnect pump at Baseline (epoprostenol) | 7.7 number of times per day | Standard Deviation 5.3 |
| Treprostinil Sodium | Change in Total Number of Times Daily Required to Disconnect Infusion Pump With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Disconnect pump at Wk 8 (Remodulin) | 4.1 number of times per day | Standard Deviation 1.9 |
Secondary
Change in Total Score on Quality of Life Questionnaire From Baseline to Week 8
The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is a health related quality of life instrument specific to PAH. The total score can range from 0 -75; the higher the score, the worse the outcome.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Total Score on Quality of Life Questionnaire From Baseline to Week 8 | CAMPHOR score at Baseline | 18.9 units on a scale | Standard Deviation 12.5 |
| Treprostinil Sodium | Change in Total Score on Quality of Life Questionnaire From Baseline to Week 8 | CAMPHOR score at Week 8 | 12.9 units on a scale | Standard Deviation 10.8 |
Comparison: Change Between Baseline and Week 8p-value: 0.203Wilcoxon signed rank test
Secondary
Change in Total Weekly Time Spent to Change Dressing With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Total Weekly Time Spent to Change Dressing With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Time to change dressing with epoprostenol at BL | 31.4 minutes | Standard Deviation 14.2 |
| Treprostinil Sodium | Change in Total Weekly Time Spent to Change Dressing With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Time to change dressing with Remdoluin at Wk 8 | 28.6 minutes | Standard Deviation 25.8 |
Comparison: Change between Baseline and Week 8p-value: 0.297Wilcoxon signed rank test
Secondary
Change in Total Weekly Time Spent to Connect Drug With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Total Weekly Time Spent to Connect Drug With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Time spent to connect epoprostenol at Baseline | 23.2 minutes | Standard Deviation 14.4 |
| Treprostinil Sodium | Change in Total Weekly Time Spent to Connect Drug With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Time spent to connect Remodulin at Week 8 | 18.7 minutes | Standard Deviation 13.9 |
Comparison: Change between Baseline and Week 8p-value: 0.207Wilcoxon signed rank test
Secondary
Change in Total Weekly Time Spent to Gather/Set-up Materials Associated With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Total Weekly Time Spent to Gather/Set-up Materials Associated With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Time to gather/set up epoprostenol at Baseline | 34.9 minutes | Standard Deviation 28.7 |
| Treprostinil Sodium | Change in Total Weekly Time Spent to Gather/Set-up Materials Associated With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Time to gather/set up Remodulin at Week 8 | 27.0 minutes | Standard Deviation 28.7 |
Comparison: Change from Baseline to Week 8p-value: 0.25Wilcoxon signed rank test
Secondary
Change in Total Weekly Time Spent to Prepare Drug With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treprostinil Sodium | Change in Total Weekly Time Spent to Prepare Drug With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Time to prepare epoprostenol at Baseline | 109.0 minutes | Standard Deviation 61 |
| Treprostinil Sodium | Change in Total Weekly Time Spent to Prepare Drug With Intravenous Remodulin Therapy Compared to Same Activities With Intravenous Epoprostenol | Time to prepare Remodulin at Week 8 | 47.8 minutes | Standard Deviation 31.6 |
Comparison: Change between Baseline and Week 8p-value: 0.004Wilcoxon signed rank test
Secondary
Change in World Health Organization (WHO) Functional Classification of PAH From Baseline to Week 8
Class I: Patients with pulmonary hypertension but without resulting limitation of physical activity. Ordinary physical activity does not cause undue dyspnea or fatigue, chest pain, or near syncope. Class II: Patients with pulmonary hypertension resulting in slight limitation of physical activity. These patients are comfortable at rest, but ordinary physical activity causes undue dyspnea or fatigue, chest pain or near syncope. Class III: Patients with pulmonary hypertension resulting in marked limitation of physical activity. They are comfortable at rest. Ordinary activity causes undue dyspnea or fatigue, chest pain, or near syncope. Class IV: Patients with pulmonary hypertension with inability to carry out any physical activity without symptoms. These patients manifest signs of right heart failure. Dyspnea and/or fatigue may be present even at rest. Discomfort is increased by any physical activity.
Time frame: Baseline and Week 8
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Treprostinil Sodium | Change in World Health Organization (WHO) Functional Classification of PAH From Baseline to Week 8 | Improved | 11 percentage of participants |
| Treprostinil Sodium | Change in World Health Organization (WHO) Functional Classification of PAH From Baseline to Week 8 | No Change | 89 percentage of participants |
| Treprostinil Sodium | Change in World Health Organization (WHO) Functional Classification of PAH From Baseline to Week 8 | Worsened | 0 percentage of participants |
Comparison: Change between Baseline and Week 8p-value: 1Wilcoxon signed rank test