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To be compliant with the timelines as agreed with Paediatric Committee (PC) within the Paediatric Investigational Plan
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The AC-052-391-study is a phase 3 study to investigate whether adding bosentan to inhaled nitric oxide in newborns with persistent pulmonary hypertension of newborns (PPHN) is a supporting and safe therapy and to evaluate the pharmacokinetics of bosentan and its metabolites.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Experimental | Bosentan |
|
| 2 | Placebo Comparator | Matching placebo |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bosentan | Drug | 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Patients With Treatment Failure | Treatment failure was defined as the need for extra corporeal membrane oxygenation or initiation of alternative pulmonary vasodilator treatment | From baseline to up to 21 days |
| Time to Complete Weaning From iNO | Calculated from the time from first study drug administration to complete weaning from iNO. Weaning from iNO was considered complete if there was no requirement for the re-initiation of iNO within 24 h after stopping | From baseline to up to 21 days |
| Time to Complete Weaning From Mechanical Ventilation | Calculated from the time from first study drug administration to complete weaning from mechanical ventilation | From baseline to up to 21 days |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Patients Requiring Re-initiation of iNO Therapy | Re-initiation of iNO therapy following weaning from iNO therapy | From baseline to up to 21 days |
| Percentage of Patients With Pulmonary Hypertension (PH) at End of Treatment |
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Inclusion Criteria:
Exclusion Criteria:
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27502103 | Derived | Steinhorn RH, Fineman J, Kusic-Pajic A, Cornelisse P, Gehin M, Nowbakht P, Pierce CM, Beghetti M; FUTURE-4 study investigators. Bosentan as Adjunctive Therapy for Persistent Pulmonary Hypertension of the Newborn: Results of the Randomized Multicenter Placebo-Controlled Exploratory Trial. J Pediatr. 2016 Oct;177:90-96.e3. doi: 10.1016/j.jpeds.2016.06.078. Epub 2016 Aug 5. |
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Term or near-term (gestational age > 34 weeks) hypoxic newborns with respiratory distress refractory to supplemental oxygen were considered, provided they had no significant structural cardiac anomalies documented in the pre-natal period and had no immediate need for extra corporeal membrane oxygenation (ECMO).
First patient, first visit was 8 December 2011 and last patient, last visit was 5 December 2013. The investigational sites were tertiary care centers with neonatal intensive care unit facilities at which inhaled nitric oxide (iNO) was used as standard of care for persistent pulmonary hypertension of the newborn (PPHN).
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| ID | Title | Description |
|---|---|---|
| FG000 | Bosentan | Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube. |
| FG001 | Placebo | Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Randomized and treated patients
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| ID | Title | Description |
|---|---|---|
| BG000 | Bosentan | Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube. |
| BG001 | Placebo |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median |
| 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 | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percentage of Patients With Treatment Failure | Treatment failure was defined as the need for extra corporeal membrane oxygenation or initiation of alternative pulmonary vasodilator treatment | Randomized and treated patients | Posted | Number | percentage of participants | From baseline to up to 21 days |
|
Up to 21 Days, plus up to 60 days after end of treatment for serious adverse events
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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 | Bosentan | Bosentan Bosentan: 2 mg/kg of weight at birth twice daily (b.i.d); quadrisectable 32 mg tablet of bosentan dispersed in sterile water and administered by nasogastric or orogastric tube. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| HEPATITIS | Hepatobiliary disorders | MedDRA version 16.0 | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| ANAEMIA | Blood and lymphatic system disorders | MedDRA version 16.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Pegah Nowbakht/Senior Clinical Trial Scientist | Actelion Pharmaceuticals Ltd | +41 61 565 68 41 | pegah.nowbakht@actelion.com |
| ID | Term |
|---|---|
| D010547 | Persistent Fetal Circulation Syndrome |
| ID | Term |
|---|---|
| D006976 | Hypertension, Pulmonary |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D007232 | Infant, Newborn, Diseases |
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| ID | Term |
|---|---|
| D000077300 | Bosentan |
| ID | Term |
|---|---|
| D000096926 | Benzenesulfonamides |
| D013449 | Sulfonamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
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|
| Matching placebo | Drug | twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube. |
|
The presence of PH was assessed by echocardiography. PH was reported as 'present' if at least one of the following criteria was met:
| From baseline to up to 14 days |
| Change in Oxygenation Index (OI) From Baseline to 3 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | 3 hours |
| Change in Oxygenation Index (OI) From Baseline to 5 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | 5 hours |
| Change in Oxygenation Index (OI) From Baseline to 12 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | 12 hours |
| Change in Oxygenation Index (OI) From Baseline to 24 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | 24 hours |
| Change in Oxygenation Index (OI) From Baseline to 48 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | 48 hours |
| Change in Oxygenation Index (OI) From Baseline to 72 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | 72 hours |
| Change in Arterial Blood Gas (ABG) pH From Baseline to 72 Hours Following Study Drug Administration | pH was determined in arterial blood samples at baseline and 72 h after the first study drug administration | 72 hours |
| Change in Arterial Blood Oxygen Saturation (SaO2) From Baseline to 72 Hours Following Study Drug Administration | SaO2 was determined in arterial blood samples at baseline and 72 h after the first study drug administration | 72 hours |
| Change in Partial Pressure of Oxygen (PaO2) in Arterial Blood From Baseline to 72 Hours Following Study Drug Administration | PaO2 was determined in arterial blood samples at baseline and 72 h after the first study drug administration | 72 hours |
| Change in Partial Pressure of Carbon Dioxide (PaCO2) in Arterial Blood From Baseline to 72 Hours Following Study Drug Administration | PaCO2 was determined in arterial blood samples at baseline and 72 h after the first study drug administration | 72 hours |
| Change in Pre-ductal Peripheral Oxygen Saturation (SpO2) From Baseline to 72 Hours Following Study Drug Administration | Simultaneous pre- (right hand) and post-ductal (lower extremities) SpO2 were measured using pulse oximetry device at baseline and 72 h after the first study drug administration | 72 hours |
| Change in Post-ductal Peripheral Oxygen Saturation (SpO2) From Baseline to 72 Hours Following Study Drug Administration | Simultaneous pre- (right hand) and post-ductal (lower extremities) SpO2 were measured using pulse oximetry device at baseline and 72 h after the first study drug administration | 72 hours |
| Change in Fraction of Inspired Oxygen (FiO2) From Baseline to 72 Hours Following Study Drug Administration | FiO2 was determined according to each study centers' standard procedure at baseline and 72 h after the first study drug administration | 72 hours |
| Maximum Whole Blood Concentration (Cmax) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Cmax was obtained directly from the measured concentrations. Cmax was corrected to a dose of 2 mg/kg bosentan (Cmaxc). The target dose was 2 mg/kg. However, as the smallest dose unit was 8 mg (quarter of a tablet), it was not possible to achieve the exact target dose in all patients. Therefore, Cmax was divided by the actual dose (in mg/kg) and multiplied by 2 mg/kg. | up to 12 hours |
| Cmax for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 5 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Cmax obtained directly from the measured concentrations . Cmax was corrected to a dose of 2 mg/kg bosentan (Cmaxc). The target dose was 2 mg/kg. However, as the smallest dose unit was 8 mg (quarter of a tablet), it was not possible to achieve the exact target dose in all patients. Therefore, Cmax was divided by the actual dose (in mg/kg) and multiplied by 2 mg/kg. | 12 hours |
| Time to Maximum Whole Blood Concentration (Tmax) for Bosentan on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations. | up to 12 hours |
| Tmax for Ro 47-8634 on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations. | up to 12 hours |
| Tmax for Ro 48-5033 on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations. | up to 12 hours |
| Tmax for Ro 64-1056 on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations. | up to 12 hours |
| Tmax for Bosentan on Day 5 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations. | 12 hours |
| Tmax for Ro 47-8634 on Day 5 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations. | 12 hours |
| Tmax for Ro 48-5033 on Day 5 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations. | 12 hours |
| Tmax for Ro 64-1056 on Day 5 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations. | 12 hours |
| Area Under the Concentration-time Curve Over a Period of 12 h (AUC0-12 Day 1)) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUC0-12 Day 1 was calculated according to the trapezoidal rule using the measured concentration-time values above the limit of quantification. | 12 hours |
| Area Under the Concentration-time Curve Over a Dosing Interval at Steady State on Day 5 (AUCtau) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUCtau Day 5 was calculated according to the trapezoidal rule using the measured concentration-time values above the limit of quantification. | 5 days |
| Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 1 (AUC0-24C Day 1) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUC0-24C Day 1 was calculated as a multiple of AUC0-12, (2 × AUC0-12 for 2 times daily dosing) corrected to 2 mg/kg. | 24 hours |
| Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 5 (AUC0-24C Day 5) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUC0-24C Day 5 was calculated as a multiple of AUCtau, (2 × AUCtau for 2 times daily dosing) corrected to 2 mg/kg. | 24 hours |
| Accumulation Index (AI) for Bosentan | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Days 1 and 5. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AI was calculated as the ratio AUCtau /AUC0-12 for the subjects having PK samples collected on Day 1 and Day 5 and with AUC0-12 > 0 ng.h/mL. | 5 days |
Matching placebo
Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube.
| BG002 | Total | Total of all reporting groups |
| days |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Number | participants |
|
| Region of Enrollment | Number | participants |
|
| Gestational age | Median | Full Range | weeks |
|
|
|
|
| Primary | Time to Complete Weaning From iNO | Calculated from the time from first study drug administration to complete weaning from iNO. Weaning from iNO was considered complete if there was no requirement for the re-initiation of iNO within 24 h after stopping | Randomized and treated patients | Posted | Median | 95% Confidence Interval | days | From baseline to up to 21 days |
|
|
|
|
| Primary | Time to Complete Weaning From Mechanical Ventilation | Calculated from the time from first study drug administration to complete weaning from mechanical ventilation | Randomized and treated patients | Posted | Median | 95% Confidence Interval | days | From baseline to up to 21 days |
|
|
|
|
| Secondary | Percentage of Patients Requiring Re-initiation of iNO Therapy | Re-initiation of iNO therapy following weaning from iNO therapy | Randomized and treated patients | Posted | Number | percentage of participants | From baseline to up to 21 days |
|
|
|
| Secondary | Percentage of Patients With Pulmonary Hypertension (PH) at End of Treatment | The presence of PH was assessed by echocardiography. PH was reported as 'present' if at least one of the following criteria was met:
| Randomized and treated patients | Posted | Number | percentage of participants | From baseline to up to 14 days |
|
|
|
|
| Secondary | Change in Oxygenation Index (OI) From Baseline to 3 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | Randomized and treated patients | Posted | Median | 95% Confidence Interval | oxygenation index | 3 hours |
|
|
|
|
| Secondary | Change in Oxygenation Index (OI) From Baseline to 5 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | Randomized and treated patients | Posted | Median | 95% Confidence Interval | oxygenation index | 5 hours |
|
|
|
|
| Secondary | Change in Oxygenation Index (OI) From Baseline to 12 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | Randomized and treated patients | Posted | Median | 95% Confidence Interval | oxygenation index | 12 hours |
|
|
|
|
| Secondary | Change in Oxygenation Index (OI) From Baseline to 24 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | Randomized and treated patients | Posted | Median | 95% Confidence Interval | oxygenation index | 24 hours |
|
|
|
|
| Secondary | Change in Oxygenation Index (OI) From Baseline to 48 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | Randomized and treated patients with available data | Posted | Median | 95% Confidence Interval | oxygenation index | 48 hours |
|
|
|
|
| Secondary | Change in Oxygenation Index (OI) From Baseline to 72 Hours Following Study Drug Administration | The change in OI from baseline following study drug administration was determined. OI was calculated as the mean airway pressure multiplied by the fraction of inspired oxygen (expressed in %), and the product was divided by the partial pressure of oxygen in arterial blood. | Randomized and treated patients with available data | Posted | Median | 95% Confidence Interval | oxygenation index | 72 hours |
|
|
|
|
| Secondary | Change in Arterial Blood Gas (ABG) pH From Baseline to 72 Hours Following Study Drug Administration | pH was determined in arterial blood samples at baseline and 72 h after the first study drug administration | Randomized and treated patients with available data | Posted | Median | 95% Confidence Interval | pH | 72 hours |
|
|
|
|
| Secondary | Change in Arterial Blood Oxygen Saturation (SaO2) From Baseline to 72 Hours Following Study Drug Administration | SaO2 was determined in arterial blood samples at baseline and 72 h after the first study drug administration | Randomized and treated patients with available data | Posted | Median | 95% Confidence Interval | percentage saturation | 72 hours |
|
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|
|
| Secondary | Change in Partial Pressure of Oxygen (PaO2) in Arterial Blood From Baseline to 72 Hours Following Study Drug Administration | PaO2 was determined in arterial blood samples at baseline and 72 h after the first study drug administration | Randomized and treated patients with available data | Posted | Median | 95% Confidence Interval | mm Hg | 72 hours |
|
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|
|
| Secondary | Change in Partial Pressure of Carbon Dioxide (PaCO2) in Arterial Blood From Baseline to 72 Hours Following Study Drug Administration | PaCO2 was determined in arterial blood samples at baseline and 72 h after the first study drug administration | Randomized and treated patients with available data | Posted | Median | 95% Confidence Interval | mm Hg | 72 hours |
|
|
|
|
| Secondary | Change in Pre-ductal Peripheral Oxygen Saturation (SpO2) From Baseline to 72 Hours Following Study Drug Administration | Simultaneous pre- (right hand) and post-ductal (lower extremities) SpO2 were measured using pulse oximetry device at baseline and 72 h after the first study drug administration | Randomized and treated patients with available data | Posted | Median | 95% Confidence Interval | percentage saturation | 72 hours |
|
|
|
|
| Secondary | Change in Post-ductal Peripheral Oxygen Saturation (SpO2) From Baseline to 72 Hours Following Study Drug Administration | Simultaneous pre- (right hand) and post-ductal (lower extremities) SpO2 were measured using pulse oximetry device at baseline and 72 h after the first study drug administration | Randomized and treated patients with available data | Posted | Median | 95% Confidence Interval | percentage saturation | 72 hours |
|
|
|
|
| Secondary | Change in Fraction of Inspired Oxygen (FiO2) From Baseline to 72 Hours Following Study Drug Administration | FiO2 was determined according to each study centers' standard procedure at baseline and 72 h after the first study drug administration | Randomized and treated patients with available data | Posted | Median | 95% Confidence Interval | percentage of oxygen | 72 hours |
|
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|
|
| Secondary | Maximum Whole Blood Concentration (Cmax) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Cmax was obtained directly from the measured concentrations. Cmax was corrected to a dose of 2 mg/kg bosentan (Cmaxc). The target dose was 2 mg/kg. However, as the smallest dose unit was 8 mg (quarter of a tablet), it was not possible to achieve the exact target dose in all patients. Therefore, Cmax was divided by the actual dose (in mg/kg) and multiplied by 2 mg/kg. | Pharmacokinetic (PK) analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Geometric Mean | 95% Confidence Interval | ng/mL | up to 12 hours |
|
|
|
| Secondary | Cmax for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 5 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Cmax obtained directly from the measured concentrations . Cmax was corrected to a dose of 2 mg/kg bosentan (Cmaxc). The target dose was 2 mg/kg. However, as the smallest dose unit was 8 mg (quarter of a tablet), it was not possible to achieve the exact target dose in all patients. Therefore, Cmax was divided by the actual dose (in mg/kg) and multiplied by 2 mg/kg. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Geometric Mean | 95% Confidence Interval | ng/mL | 12 hours |
|
|
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| Secondary | Time to Maximum Whole Blood Concentration (Tmax) for Bosentan on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Median | Full Range | hours | up to 12 hours |
|
|
|
| Secondary | Tmax for Ro 47-8634 on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Median | Full Range | hours | up to 12 hours |
|
|
|
| Secondary | Tmax for Ro 48-5033 on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Median | Full Range | hours | up to 12 hours |
|
|
|
| Secondary | Tmax for Ro 64-1056 on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Tmax was obtained directly from the measured concentrations. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Median | Full Range | hours | up to 12 hours |
|
|
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| Secondary | Tmax for Bosentan on Day 5 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Median | Full Range | hours | 12 hours |
|
|
|
| Secondary | Tmax for Ro 47-8634 on Day 5 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Median | Full Range | hours | 12 hours |
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|
| Secondary | Tmax for Ro 48-5033 on Day 5 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Median | Full Range | hours | 12 hours |
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| Secondary | Tmax for Ro 64-1056 on Day 5 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Tmax was obtained directly from the measured concentrations. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Median | Full Range | hours | 12 hours |
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| Secondary | Area Under the Concentration-time Curve Over a Period of 12 h (AUC0-12 Day 1)) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 on Day 1 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUC0-12 Day 1 was calculated according to the trapezoidal rule using the measured concentration-time values above the limit of quantification. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Geometric Mean | 95% Confidence Interval | h*ng/mL | 12 hours |
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| Secondary | Area Under the Concentration-time Curve Over a Dosing Interval at Steady State on Day 5 (AUCtau) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUCtau Day 5 was calculated according to the trapezoidal rule using the measured concentration-time values above the limit of quantification. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Geometric Mean | 95% Confidence Interval | h*ng/mL | 5 days |
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| Secondary | Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 1 (AUC0-24C Day 1) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Day 1. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUC0-24C Day 1 was calculated as a multiple of AUC0-12, (2 × AUC0-12 for 2 times daily dosing) corrected to 2 mg/kg. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Geometric Mean | 95% Confidence Interval | h*ng/mL | 24 hours |
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| Secondary | Area Under the Concentration-time Curve Over a Period of 24 h (Dose-corrected to 2 mg/kg) on Day 5 (AUC0-24C Day 5) for Bosentan and Its Metabolites, Ro 47-8634, Ro 48-5033, and Ro 64-1056 | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to study drug administration and at 0.5, 1, 2, 3, 7.5, and 12 hours post-dose on Day 5. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AUC0-24C Day 5 was calculated as a multiple of AUCtau, (2 × AUCtau for 2 times daily dosing) corrected to 2 mg/kg. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Geometric Mean | 95% Confidence Interval | h*ng/mL | 24 hours |
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| Secondary | Accumulation Index (AI) for Bosentan | Concentrations were measured directly in dried blood spot samples scheduled to be taken immediately prior to first study drug administration and at 0.5, 1, 2, 3, 7.5 and 12 hours post-dose on Days 1 and 5. Pharmacokinetic parameters were determined on the basis of scheduled blood sampling time points using non-compartmental analysis. Actual blood sampling times were used only if there was a deviation of more than 5% from the scheduled times. AI was calculated as the ratio AUCtau /AUC0-12 for the subjects having PK samples collected on Day 1 and Day 5 and with AUC0-12 > 0 ng.h/mL. | PK analysis set. This analysis set comprised all patients included in the all-treated set who were able to provide at least 5 of the 7 blood samples requested for at least one evaluable profile of PK assessment and who did not violate the protocol in a way that might affect the evaluation of the PK endpoints. | Posted | Geometric Mean | 95% Confidence Interval | accumulation index | 5 days |
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| 2 |
| 13 |
| 9 |
| 13 |
| EG001 | Placebo | Matching placebo Matching placebo: twice daily (b.i.d); quadrisectable 32 mg tablet of matching placebo dispersed in sterile water and administered by nasogastric or orogastric tube. | 3 | 8 | 2 | 8 |
| METABOLIC ACIDOSIS | Metabolism and nutrition disorders | MedDRA version 16.0 | Systematic Assessment |
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| HYPERCAPNIA | Respiratory, thoracic and mediastinal disorders | MedDRA version 16.0 | Systematic Assessment |
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| PNEUMOTHORAX | Respiratory, thoracic and mediastinal disorders | MedDRA version 16.0 | Systematic Assessment |
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| CIRCULATORY COLLAPSE | Vascular disorders | MedDRA version 16.0 | Systematic Assessment |
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| SEPSIS | Infections and infestations | MedDRA version 16.0 | Systematic Assessment |
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| GENERALISED OEDEMA | General disorders | MedDRA version 16.0 | Systematic Assessment |
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| COAGULOPATHY | Blood and lymphatic system disorders | MedDRA version 16.0 | Systematic Assessment |
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| VOMITING | Gastrointestinal disorders | MedDRA version 16.0 | Systematic Assessment |
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| BILIRUBIN CONJUGATED INCREASED | Investigations | MedDRA version 16.0 | Systematic Assessment |
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| BODY TEMPERATURE INCREASED | Investigations | MedDRA version 16.0 | Systematic Assessment |
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| C-REACTIVE PROTEIN INCREASED | Investigations | MedDRA version 16.0 | Systematic Assessment |
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| DYSPHONIA | Respiratory, thoracic and mediastinal disorders | MedDRA version 16.0 | Systematic Assessment |
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| ENDOTRACHEAL INTUBATION COMPLICATION | Injury, poisoning and procedural complications | MedDRA version 16.0 | Systematic Assessment |
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| GASTRIC HAEMORRHAGE | Gastrointestinal disorders | MedDRA version 16.0 | Systematic Assessment |
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| HYPOGLYCAEMIA | Metabolism and nutrition disorders | MedDRA version 16.0 | Systematic Assessment |
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| HYPOKALAEMIA | Metabolism and nutrition disorders | MedDRA version 16.0 | Systematic Assessment |
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| HYPOPHOSPHATAEMIA | Metabolism and nutrition disorders | MedDRA version 16.0 | Systematic Assessment |
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| INFECTIOUS DISEASE CARRIER | Infections and infestations | MedDRA version 16.0 | Systematic Assessment |
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| METABOLIC ACIDOSIS | Metabolism and nutrition disorders | MedDRA version 16.0 | Systematic Assessment |
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| METHAEMOGLOBINAEMIA | Blood and lymphatic system disorders | MedDRA version 16.0 | Systematic Assessment |
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| MITRAL VALVE INCOMPETENCE | Cardiac disorders | MedDRA version 16.0 | Systematic Assessment |
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| PNEUMOMEDIASTINUM | Respiratory, thoracic and mediastinal disorders | MedDRA version 16.0 | Systematic Assessment |
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| PNEUMOTHORAX | Respiratory, thoracic and mediastinal disorders | MedDRA version 16.0 | Systematic Assessment |
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| PROCEDURAL COMPLICATION | Injury, poisoning and procedural complications | MedDRA version 16.0 | Systematic Assessment |
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| THROMBOCYTOPENIA | Blood and lymphatic system disorders | MedDRA version 16.0 | Systematic Assessment |
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Not provided
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D001555 |
| Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D013450 | Sulfones |
| D013457 | Sulfur Compounds |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| Change from baseline |
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| Change from baseline |
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| Change from baseline |
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| Change from baseline |
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| Change from baseline |
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| Change from baseline |
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| Change from baseline |
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| Change from baseline |
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| Change from baseline |
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| Change from baseline |
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| Change from baseline |
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| Change from baseline |
|
| Change from baseline |
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| Title | Measurements |
|---|---|
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| Ro 64-1056 |
|
| Title | Measurements |
|---|---|
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| Ro 64-1056 |
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| Title | Measurements |
|---|---|
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| Ro 64-1056 |
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| Title | Measurements |
|---|---|
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| Ro 64-1056 |
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| Title | Measurements |
|---|---|
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| Ro 64-1056 |
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| Title | Measurements |
|---|---|
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| Ro 64-1056 |
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