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A randomized, double-blind, placebo-controlled dose escalation study to assess the safety and efficacy of pulsed, inhaled nitric oxide (iNO) in subjects with pulmonary fibrosis on long term oxygen therapy.
A Phase 2b, randomized, double-blind, placebo-controlled dose escalation clinical study to assess the safety and efficacy of pulsed, inhaled nitric oxide in subjects with and without pulmonary hypertension associated with pulmonary fibrosis on long term oxygen therapy (Part 1 and Part 2)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Inhaled Nitric Oxide (iNO) | Active Comparator | Pulsed inhaled iNO30, 45 and 75 mcg/kg Ideal Body Weight (IBW)/hour (hr) |
|
| Placebo | Placebo Comparator | Pulsed inhaled N2, 99.999% gas |
|
| Long Term Follow Up | Active Comparator | Pulsed inhaled iNO30, 45 or 75 mcg/kg IBW/hr |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| INOpulse® | Combination Product | Patients will be treated by means of an INOpulse® device using an INOpulse® nasal cannula |
|
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy of escalating doses of iNO in patient's life participation as assessed in minutes per day of moderate to vigorous activity. | Part 1 - Blinded Treatment Period | Change from baseline to week 8 or 16 |
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| Measure | Description | Time Frame |
|---|---|---|
| Change in 6-minute walking test (6MWT) from baseline | Part 1 - Blinded Treatment Period | Change from baseline to week 8 or 16 |
| Difference in activity as measured using ActiGraph devices | Part 1 - Blinded Treatment Period |
Inclusion Criteria:
Diagnosed with pulmonary fibrosis by high resolution CT scan performed in the 6 months prior to screening associated with one of the following conditions and confirmed using one of the following guidelines, as per American Thoracic Society (AGS) / European Respiratory Society (ERS) / Japanese Respiratory Society (JRS) / Latin American Thoracic Association (ALAT):
Major idiopathic interstitial pneumonias (IIPs) diagnosis or suspected as one of the following:
Rare IIPs diagnosis by one of the following:
Unclassifiable idiopathic interstitial pneumonias
Chronic hypersensitivity pneumonitis
Occupational lung disease
Have been using oxygen therapy by nasal cannula for at least 4 weeks
6-Minute Walk Distance (6MWD) ≥ 100 meters and ≤ 450 meters at screening and Baseline/Randomization visits
World Health Organization (WHO) Functional Class II-IV
Forced Vital Capacity ≥ 40% predicated within the last 6 months prior to the screening run-in period
Age between 18 and 85 years (inclusive)
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ashika Ahmed, MD | Bellerophon Therapeutics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Arizona Pulmonary Specialists | Phoenix | Arizona | 85012 | United States | ||
| University of California |
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| Placebo | Combination Product | Patients will be treated by means of an INOpulse® device using an INOpulse® nasal cannula |
|
| Long Term Follow Up | Combination Product | Patients will be treated by means of an INOpulse® device using an INOpulse® nasal cannula |
|
| Change from baseline to week 8 or 16 |
| Percentage of patients with ≥15% decrease in activity | Part 1 - Blinded Treatment Period | Change from baseline to to week 8 or 16 |
| Difference in dyspnea as measured by University of California San Diego Shortness of Breath Questionnaire | The University of California San Diego Shortness of Breath Questionnaire is a 24-item questionnaire developed to measure breathlessness associated with activities of daily living, on a scale between zero and five where 0 is not at all breathless and 5 is maximally breathless or too breathless to do the activity. The responses to all items are summed up to provide the overall score that can range from 0 (best outcome) to 120 (worst outcome). | Change from baseline to to week 8 or 16 |
| Difference in St. George Respiratory Questionnaire and sub-groups | St. George Respiratory Questionnaire and sub-groups is a tool for assessing quality of life that has previously been validated for the use with patients with interstitial lung disease. It is a responsive tool that has three domains: symptoms, activity and impact (on daily life) | Change from baseline to to week 8 or 16 |
| Percentage of patients with a clinically meaningful difference (reduction of at least 4 points) in the disease-specific quality of life measured using the disease specific St. George Respiratory Questionnaire (SGRQ) | Part 1 - Blinded Treatment Period | Change from baseline to to week 8 or 16 |
| Change in N-terminal (NT)-ProBNP (absolute and percentage) | Part 1 - Blinded Treatment Period | Change from baseline to week 8 or 16 |
| Time to clinical improvement | Part 1 - Blinded Treatment Period | Baseline to week 8 or 16 |
| Time to clinical worsening | Part 1 - Blinded Treatment Period | Baseline to week 8 or 16 |
| Incidence and severity of treatment emergent adverse events, including those related to INOpulse® device deficiency | Part 1 - Blinded Treatment Period | Baseline to week 8 or 16 |
| Adverse events that may be due to rebound associated with a temporal acute withdrawal of investigational study drug | Part 1 - Blinded Treatment Period | Baseline to week 8 or 16 |
| Change in diffusing capacity of the lungs for carbon monoxide (DLCO) | Part 1 - Blinded Treatment Period | Baseline to week 8 or 16 |
| Mortality | Part 1 - Blinded Treatment Period | Baseline to week 8 or 16 |
| Hospitalization (all cause and for cardiopulmonary or other cause) | Part 1 - Blinded Treatment Period | Baseline to week 8 or 16 |
| Change in Forced Expiratory Volume at 1 minute (FEV1) | Part 1 - Blinded Treatment Period | Baseline to week 8 or 16 |
| Change in Forced Vital Capacity (FVC) | Part 1 - Blinded Treatment Period | Baseline to week 8 or 16 |
| Los Angeles |
| California |
| 90024 |
| United States |
| University of California Davis Health | Sacramento | California | 95817 | United States |
| University of Colorado Hospital | Aurora | Colorado | 80045 | United States |
| University of Miami | Miami | Florida | 33125 | United States |
| Avanza Medical Research Center | Pensacola | Florida | 32503 | United States |
| Emory University | Atlanta | Georgia | 30322 | United States |
| Piedmont Healthcare Pulmonary & Critical Care Research | Austell | Georgia | 30106 | United States |
| Loyola University | Chicago | Illinois | 60153 | United States |
| Norton Pulmonary Specialists | Louisville | Kentucky | 40202-1332 | United States |
| University of Michigan | Ann Arbor | Michigan | 48109 | United States |
| The Lung Research Center (St. Luke's) | Chesterfield | Missouri | 63017 | United States |
| The University of North Carolina at Chapel Hill | Chapel Hill | North Carolina | 27517 | United States |
| University of Cincinnati College of Medicine | Cincinnati | Ohio | 45267 | United States |
| Thomas Jefferson University Korman Respiratory Institute | Philadelphia | Pennsylvania | 19017 | United States |
| Temple University Hospital | Philadelphia | Pennsylvania | 19140 | United States |
| Medical University of South Carolina | Charleston | South Carolina | 29425 | United States |
| Vanderbilt University Medical Center | Nashville | Tennessee | 37232 | United States |
| University of Texas Southwestern Medical Center | Dallas | Texas | 75390 | United States |
| University of Utah Health Sciences | Salt Lake City | Utah | 84108 | United States |
| Inova Heart and Vascular Institute Advanced Lung Disease Clinic | Falls Church | Virginia | 22042 | United States |
| Pulmonary Associates of Richmond | Richmond | Virginia | 23229 | United States |
| University of Washington Medical Center | Seattle | Washington | 98195 | United States |
| ID | Term |
|---|---|
| D011658 | Pulmonary Fibrosis |
| D006976 | Hypertension, Pulmonary |
| ID | Term |
|---|---|
| D017563 | Lung Diseases, Interstitial |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D005355 | Fibrosis |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D006973 | Hypertension |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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