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The TDE-DU-202 extension study was discontinued after the randomized, placebo-controlled TDE-DU-201 study did not meet its primary efficacy objective.
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This open label extension trial will allow ongoing treatment of subjects who participated in the randomized controlled trials, and will provide long term information about the safety of treprostinil diethanolamine SR in subjects with SSc and digital ulcers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treprostinil | Experimental | Treprostinil diethanolamine sustained release tablet initiated at 0.25 mg and titrated up to a maximum dose of 16 mg BID or the individual's maximum tolerated dose (MTD). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| treprostinil diethanolamine | Drug | sustained release tablet; BID dosing; up to 16 mg BID |
|
| Measure | Description | Time Frame |
|---|---|---|
| Net Ulcer Burden- Mean Change From Time of Study Entry for Each Scheduled Visit Assessment | Net ulcer burden at any given assessment was defined as the number of "new" or "active" ulcers at that assessment, plus the number of "indeterminate" ulcers at that assessment that had previously been classified as either "active" or "new" at any earlier assessment during the study. The mean change in net ulcer burden from time of study entry was summarized for each scheduled visit assessment. | Baseline and Months 1, 3, 6, 9, 12, and 18 |
| Total Ulcer Number- Mean Change From Time of Study Entry for Each Scheduled Visit Assessment | The total ulcer number includes all ulcers designated as "active", "indeterminate", or "new" for a given visit. The mean change in the total number of ulcers present from time of study entry was summarized for each scheduled visit assessment. | Baseline and Months 1, 3, 6, 9, 12, and 18 |
| Formation of New Ulcers | The number and percentage of subjects who developed new ulcers during the study were summarized. | 18 months (or last study visit) |
| Measure | Description | Time Frame |
|---|---|---|
| Patient Function and QOL Measure: Scleroderma Health Assessments Questionnaire (SHAQ)- Mean Change From Study Entry in SHAQ Component Scores at Each Scheduled Assessment | The SHAQ consists of 20 health assessment questionnaire questions with integer responses of 0 (without any difficulty) to 3 (unable to do), and five scleroderma-specific visual analog scale (VAS) domains (Overall Disease Activity, Raynaud's Phenomenon, Finger Ulcers, Breathing, and Intestinal Problems) with values ranging from 0.0 to 15.0 centimeters. The questions are divided into eight component domains: Dressing & Grooming, Arising, Eating, Walking, Hygiene, Reach, Grip, and Activities. Each domain score is calculated by summing the domain responses and dividing by the number of questions in that domain. Each VAS domain score is calculated by dividing the value in centimeters by 5. SHAQ component and VAS domain score ranges from 0 (least limitation) to 3 (most limitation). The aggregate SHAQ score is calculated by dividing the sum of all domain scores by 13, with a score ranging from 0 (least limitation) to 3 (most limitation). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| James Seibold, MD | Scleroderma Research Consultants LLC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Alabama - Birmingham - Arthritis Clinical Intervention Program | Birmingham | Alabama | 35294-7201 | United States | ||
Eligible subjects who completed assessments for the final visit of the previous controlled trial, TDE-DU-201, were eligible to enroll in this extension study. Data from this final study visit served as Baseline data. A total of 115 subjects were enrolled, with 115 subjects receiving study medication at an initial dose of 0.25 mg twice daily (BID).
Subjects were recruited to enroll in 26 centers in the US, Canada, and the UK in this open-label trial within 14 days of completion of TDE-DU-201. Subjects who prematurely terminated the previous controlled trial were not eligible. Data from the final study visit of the previous trial served as Baseline data and subject blinding was maintained.
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| ID | Title | Description |
|---|---|---|
| FG000 | Oral Treprostinil Diethanolamine | Oral Treprostinil Diethanolamine initiated at 0.25 mg and titrated up to a maximum dose of 16 mg BID or the individual's maximum tolerated dose (MTD). |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Baseline and Months 1, 3, 6, and 12 |
| Patient Function and Quality of Life Measure: Cochin Hand Function Scale (CHFS)-Mean Change From Study Entry in CHFS Score at Each Scheduled Assessment | The CHFS score is derived from 18 validated questions that assess functional disability and handicap due to hand involvement in rheumatoid arthritis. Each answer is scored on a scale with possible integer responses of 0(without difficulty) to 5 (impossible). The CHFS score is simply the sum of all 18 questions, divided by the number of questions actually answered, multiplied by 18. At least 10 of the 18 questions must have been answered in order for CHFS to be calculated. Therefore, CHFS score values can range from 0 (least limitation) to 90 (most limitation), with improvements in function or reduction of limitation indicated a decreased score value. The mean change from study entry in CHFS scores at each scheduled assessment are summarized. | Baseline and Months 1, 3, 6, and 12 |
| Mayo Clinic Scottsdale |
| Scottsdale |
| Arizona |
| 85259 |
| United States |
| UCLA | Los Angeles | California | 90095-1670 | United States |
| Barbara Davis Centre | Aurora | Colorado | 80045 | United States |
| University of Connecticut Health Center | Farmington | Connecticut | 06030-1310 | United States |
| Georgetown University - Dept. of Medicine/Rheumatology | Washington D.C. | District of Columbia | 20007 | United States |
| Northwestern University - Feinberg School of Medicine | Chicago | Illinois | 60611 | United States |
| Johns Hopkins University - Division of Rheumatology | Baltimore | Maryland | 21224 | United States |
| Boston University School of Medicine | Boston | Massachusetts | 02118-2526 | United States |
| University of Michigan - Scleroderma Program | Ann Arbor | Michigan | 48106 | United States |
| University of Minnesota | Minneapolis | Minnesota | 55455 | United States |
| UMDNJ Clinical Research Center | New Brunswick | New Jersey | 08903 | United States |
| North Shore - LIJ Health System | Lake Success | New York | 11042 | United States |
| The Hospital for Special Surgery | New York | New York | 10021 | United States |
| The Cleveland Clinic Foundation | Cleveland | Ohio | 44195 | United States |
| University of Toledo | Toledo | Ohio | 43614 | United States |
| University of Pittsburgh | Pittsburgh | Pennsylvania | 15261 | United States |
| Medical University of South Carolina | Charleston | South Carolina | 29425-8900 | United States |
| University of Texas - Houston | Houston | Texas | 77030 | United States |
| University of Utah | Salt Lake City | Utah | 84132 | United States |
| Virginia Mason Medical | Seattle | Washington | 98101 | United States |
| Medical College of Wisconsin | Milwaukee | Wisconsin | 53226 | United States |
| St Joseph's Health Care | London | Ontario | N6A 4V2 | Canada |
| Jewish General Hospital | Montreal | Quebec | H3T 1E2 | Canada |
| Royal Free Hospital - Center for Rheumatology | London | NW3 2QG | United Kingdom |
| Salford Royal Hospital | Manchester | M13 9PT | United Kingdom |
| COMPLETED |
|
| NOT COMPLETED |
|
|
Efficacy was assessed using data obtained at each visit, if available, from all subjects enrolled in this study. Assessments performed after discontinuation of study drug were excluded from the summaries. All subjects who had at least one dose of study drug documented were included in the safety analysis population.
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| ID | Title | Description |
|---|---|---|
| BG000 | Oral Treprostinil Diethanolamine | Oral Treprostinil Diethanolamine initiated at 0.25 mg and titrated up to a maximum dose of 16 mg BID or the individual's maximum tolerated dose (MTD). |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Full Range | years |
| ||||||||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| |||||||||||||||||||||||
| Race/Ethnicity, Customized | *Note a subject can be included in more than one race category | Number | participants |
| ||||||||||||||||||||||
| Years since scleroderma diagnosis | Mean | Full Range | years |
| ||||||||||||||||||||||
| Scleroderma Classification | Systemic sclerosis (SSc) is commonly categorized into diffuse and limited forms but can also include the overlap syndrome (associated with other connective tissue diseases). The main distinguishing feature of the diffuse form is skin involvement proximal to the elbows and ankles and a higher risk of internal organ involvement. In limited SSc, skin involvement is confined to face, hands, feet, or forearms; however, a significant proportion of patients develop pulmonary hypertension. | Number | participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Secondary | Patient Function and QOL Measure: Scleroderma Health Assessments Questionnaire (SHAQ)- Mean Change From Study Entry in SHAQ Component Scores at Each Scheduled Assessment | The SHAQ consists of 20 health assessment questionnaire questions with integer responses of 0 (without any difficulty) to 3 (unable to do), and five scleroderma-specific visual analog scale (VAS) domains (Overall Disease Activity, Raynaud's Phenomenon, Finger Ulcers, Breathing, and Intestinal Problems) with values ranging from 0.0 to 15.0 centimeters. The questions are divided into eight component domains: Dressing & Grooming, Arising, Eating, Walking, Hygiene, Reach, Grip, and Activities. Each domain score is calculated by summing the domain responses and dividing by the number of questions in that domain. Each VAS domain score is calculated by dividing the value in centimeters by 5. SHAQ component and VAS domain score ranges from 0 (least limitation) to 3 (most limitation). The aggregate SHAQ score is calculated by dividing the sum of all domain scores by 13, with a score ranging from 0 (least limitation) to 3 (most limitation). | Efficacy was assessed by the change in net ulcer burden and in the total ulcer number from Baseline at each of the follow-up visits and the percentage of subjects with formation of new ulcers during the study. Assessments performed after discontinuation of study drug were excluded from the summaries. | Posted | Mean | Standard Deviation | units on a scale | Baseline and Months 1, 3, 6, and 12 |
|
|
| |||||||||||||||||||||||||||||||||||
| Primary | Net Ulcer Burden- Mean Change From Time of Study Entry for Each Scheduled Visit Assessment | Net ulcer burden at any given assessment was defined as the number of "new" or "active" ulcers at that assessment, plus the number of "indeterminate" ulcers at that assessment that had previously been classified as either "active" or "new" at any earlier assessment during the study. The mean change in net ulcer burden from time of study entry was summarized for each scheduled visit assessment. | Efficacy was assessed using data obtained at each visit, if available, from all subjects enrolled in this study. Assessments performed after discontinuation of study drug were excluded from the summaries. | Posted | Mean | Standard Deviation | ulcers | Baseline and Months 1, 3, 6, 9, 12, and 18 |
|
| ||||||||||||||||||||||||||||||||||||
| Secondary | Patient Function and Quality of Life Measure: Cochin Hand Function Scale (CHFS)-Mean Change From Study Entry in CHFS Score at Each Scheduled Assessment | The CHFS score is derived from 18 validated questions that assess functional disability and handicap due to hand involvement in rheumatoid arthritis. Each answer is scored on a scale with possible integer responses of 0(without difficulty) to 5 (impossible). The CHFS score is simply the sum of all 18 questions, divided by the number of questions actually answered, multiplied by 18. At least 10 of the 18 questions must have been answered in order for CHFS to be calculated. Therefore, CHFS score values can range from 0 (least limitation) to 90 (most limitation), with improvements in function or reduction of limitation indicated a decreased score value. The mean change from study entry in CHFS scores at each scheduled assessment are summarized. | Efficacy was assessed by the change in net ulcer burden and in the total ulcer number from Baseline at each of the follow-up visits and the percentage of subjects with formation of new ulcers during the study. Assessments performed after discontinuation of study drug were excluded from the summaries. | Posted | Mean | Standard Deviation | units on a scale | Baseline and Months 1, 3, 6, and 12 |
| |||||||||||||||||||||||||||||||||||||
| Primary | Total Ulcer Number- Mean Change From Time of Study Entry for Each Scheduled Visit Assessment | The total ulcer number includes all ulcers designated as "active", "indeterminate", or "new" for a given visit. The mean change in the total number of ulcers present from time of study entry was summarized for each scheduled visit assessment. | Efficacy was assessed by the change in net ulcer burden and in the total ulcer number from Baseline at each of the follow-up visits and the percentage of subjects with formation of new ulcers during the study. Assessments performed after discontinuation of study drug were excluded from the summaries. | Posted | Mean | Standard Deviation | number of ulcers | Baseline and Months 1, 3, 6, 9, 12, and 18 |
|
| ||||||||||||||||||||||||||||||||||||
| Primary | Formation of New Ulcers | The number and percentage of subjects who developed new ulcers during the study were summarized. | Efficacy was assessed by the change in net ulcer burden and in the total ulcer number from Baseline at each of the follow-up visits and the percentage of subjects with formation of new ulcers during the study. Assessments performed after discontinuation of study drug were excluded from the summaries. | Posted | Number | participants | 18 months (or last study visit) |
|
|
48 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Oral Treprostinil Diethanolamine | Oral Treprostinil Diethanolamine initiated at 0.25 mg and titrated up to a maximum dose of 16 mg BID or the individual's maximum tolerated dose (MTD). | 17 | 115 | 113 | 115 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Gastroenteritis | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Infected skin ulcer | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Infection | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Osteomyelitis | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Pneumonia | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Respiratory tract infection | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Anemia | Blood and lymphatic system disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Pancytopenia | Blood and lymphatic system disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Skin ulcer | Skin and subcutaneous tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Ingrowing nail | Skin and subcutaneous tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Cardiac arrest | Cardiac disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Coronary artery disease | Cardiac disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Pericardial effusion | Cardiac disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Non-cardiac chest pain | General disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Pyrexia | General disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Renal failure acute | Renal and urinary disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Femoral artery occlusion | Vascular disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Thrombosis | Vascular disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Impaired gastric emptying | Gastrointestinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Cholecystitis | Hepatobiliary disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Pelvic fracture | Injury, poisoning and procedural complications | MedDRA (12.0) | Non-systematic Assessment |
| |
| Renal cell carcinoma recurrent | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (12.0) | Non-systematic Assessment |
| |
| Hypoxic-ischaemic encephalopathy | Nervous system disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Prostatitis | Reproductive system and breast disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Bronchiectasis | Respiratory, thoracic and mediastinal disorders | MedDRA (12.0) | Non-systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headache | Nervous system disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Dizziness | Nervous system disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Migraine | Nervous system disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Diarrhea | Gastrointestinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Gastrooesophageal reflux disease | Gastrointestinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Constipation | Gastrointestinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Abdominal discomfort | Gastrointestinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Abdominal pain upper | Gastrointestinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Dyspepsia | Gastrointestinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Flatulence | Gastrointestinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Pain in jaw | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Muscle spasms | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Joint swelling | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Neck pain | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Infected skin ulcer | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Localised infection | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Influenza | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Sinusitis | Infections and infestations | MedDRA (12.0) | Non-systematic Assessment |
| |
| Fatigue | General disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Oedema peripheral | General disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Pain | General disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Pyrexia | General disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Asthenia | General disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Skin ulcer | Skin and subcutaneous tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Rash | Skin and subcutaneous tissue disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Flushing | Vascular disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Dyspnea | Respiratory, thoracic and mediastinal disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Insomnia | Psychiatric disorders | MedDRA (12.0) | Non-systematic Assessment |
| |
| Decreased appetite | Metabolism and nutrition disorders | MedDRA (12.0) | Non-systematic Assessment |
|
Interpretation of the change in digital ulcer status was limited by the lack of a control group and the discontinuation of the study prior to subjects completing all scheduled visits.
Any publication of the results of this trial must be consistent with the United Therapeutics publication policy. The rights of the investigator and of the sponsor with regard to publication of the results of this trial are described in the investigator contract.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Rex Mauthe, Assoc VP, Regulatory Affairs | United Therapeutics Corporation | (919) 485-8350 | RMauthe@unither.com |
| ID | Term |
|---|---|
| D012595 | Scleroderma, Systemic |
| D045743 | Scleroderma, Diffuse |
| C000721267 | digital ulcers |
| D014652 | Vascular Diseases |
| ID | Term |
|---|---|
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D012871 | Skin Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| C427248 | treprostinil |
Not provided
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| African-American |
|
| Native American |
|
| Not provided |
|
|
| Title | Measurements |
|---|---|
|
| Month 12 |
|
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| Units | Counts |
|---|
| Participants |
|
|
|
|