Treprostinil

Clinical trials are investigating Treprostinil in several lung diseases, including pulmonary arterial hypertension and fibrotic lung disease. These studies look at whether Treprostinil can improve outcomes, slow worsening, and remain safe in different patient groups. They also compare Treprostinil with placebo or with other treatment strategies.

Table of contents

Clinical trials overview

The trial data shows that Treprostinil is being studied in several different lung conditions, not just one disease.[1] These studies are looking at whether it can help people with pulmonary arterial hypertension, idiopathic pulmonary fibrosis, progressive pulmonary fibrosis, fibrotic lung disease, and pulmonary hypertension associated with interstitial lung disease.[1]

Most of the trials in the source data are Phase 3 studies, which are late-stage trials that test how well a treatment works and how safe it is in larger groups.[2] One study is listed as Low Intervention, which means the study plan uses a lower level of intervention than a typical drug trial, but it is still testing treatment effects.[1]

Pulmonary arterial hypertension study

The TripleTRE study is a randomized trial in people with pulmonary arterial hypertension (group I).[1] It compares initial triple therapy, which includes oral ERA, oral PDE-5i, and parenteral Treprostinil, with initial double oral therapy using oral ERA and oral PDE-5i.[1]

This study is designed to see whether starting with the triple treatment plan can improve risk status compared with the double oral plan.[1] Risk status is a way to judge how serious the disease is and how likely it is to get worse.[1]

The main outcome is whether a person becomes a therapy-responder or a therapy-non-responder between week 12 and week 48.[1] A responder is someone who reaches low-risk status between week 24 and week 48, while a non-responder is someone who has disease worsening, needs extra medication, changes treatment because it is not working well enough, or does not reach low-risk status by week 48.[1]

Fibrotic lung disease studies

One Phase 3 extension study is looking at people with fibrotic lung disease and is focused on the long-term safety and tolerability of inhaled Treprostinil.[3] The study is large, with an enrollment of 1,843 participants, and it is authorised.[3]

This study measures several signs of benefit and disease control, including change in absolute FVC, time to clinical worsening, time to acute exacerbation, overall survival, change in % predicted FVC, K-BILD score, N-terminal pro-brain natriuretic peptide, DLCO, and resting supplemental oxygen use.[3] It also checks safety using adverse events, serious adverse events, laboratory tests, vital signs, oxygen saturation, and electrocardiograms.[3]

Progressive pulmonary fibrosis study

The TETON-PPF study is a randomized, double-blind, placebo-controlled, multinational Phase 3 trial in people with progressive pulmonary fibrosis.[4] Double-blind means that neither the patient nor the study team knows who receives the study drug or placebo during the trial.[4]

The main goal is to compare inhaled Treprostinil with placebo for the change in absolute FVC from baseline to week 52.[4] FVC is a lung function test that shows how much air a person can breathe out after a deep breath.[4]

Pulmonary hypertension and interstitial lung disease study

The 2024-517943-29-00 study tests a new inhaled treatment called L606 in people with pulmonary hypertension associated with interstitial lung disease, also called WHO Group 3.[5] The trial is Phase 3, authorised, and plans to enroll 343 participants.[5]

Although the study is described as testing L606, the intervention list includes Treprostinil Liposome and placebo inhalation suspension.[5] The main outcome is the change from baseline to week 16 in 6-minute walk distance, which checks how far a person can walk in 6 minutes.[5]

What the trials measure

The trial data uses a mix of efficacy and safety endpoints.[1][3][4][5]

Efficacy means how well the treatment works, and safety means how well it is tolerated and what unwanted medical problems may happen during the study.[3]

  • FVC is used in the IPF and PPF studies to see whether lung function changes over time.[3][4]
  • 6-minute walk distance is used to measure exercise ability in the WHO Group 3 study.[5]
  • Clinical worsening includes serious signs such as death, respiratory hospitalization, or a major decline in lung function.[3]
  • Overall survival checks whether people are alive during the study period.[3]
  • Safety checks include side effects, lab tests, vital signs, oxygen saturation, and ECGs.[3]

What participation means

These trials are not open to everyone with breathing problems; each study has specific target populations based on the diagnosis.[1] For example, one study is for group I pulmonary arterial hypertension, while others focus on fibrotic lung disease, idiopathic pulmonary fibrosis, progressive pulmonary fibrosis, or pulmonary hypertension linked to interstitial lung disease.[1]

The studies also use different treatment plans, such as inhaled Treprostinil, parenteral Treprostinil, placebo, or combination therapy with other pulmonary hypertension medicines.[1][4][5]

Because the trials measure both benefit and safety, they are designed to show not only whether Treprostinil may help, but also whether the treatment plan can be used over time in the studied groups.[3][4]

Trial ID Phase Condition studied Status Enrollment
2023-504351-26-01 Low Intervention Pulmonary arterial hypertension (group I) Authorised 133
NCT05255991 Phase 3 Idiopathic Pulmonary Fibrosis Completed 815
NCT04905693 Phase 3 Fibrotic Lung Disease Authorised 1843
NCT05943535 Phase 3 Progressive Pulmonary Fibrosis Authorised 725
2024-517943-29-00 Phase 3 Pulmonary Hypertension associated with interstitial lung disease (WHO Group 3) Authorised 343

Ongoing Clinical Trials on Treprostinil

  • A study to evaluate the safety and effectiveness of inhaled treprostinil in patients with pulmonary hypertension associated with interstitial lung disease

    Recruiting

    1 1
    Investigated drugs:
    Austria Belgium Czechia France Germany Italy +4
  • Study on the Effects of Inhaled Treprostinil for Patients with Progressive Pulmonary Fibrosis

    Recruiting

    1 1
    Investigated diseases:
    Investigated drugs:
    Belgium France Germany Italy Spain
  • Study on the Effectiveness and Safety of Treprostinil and Drug Combination for Patients with Pulmonary Arterial Hypertension (Group I)

    Recruiting

    1 1 1 1
    Investigated diseases:
    Investigated drugs:
    Austria Czechia France Germany Hungary Italy +6
  • Study on Long-Term Safety of Inhaled Treprostinil for Patients with Fibrotic Lung Disease

    Recruiting

    1 1 1
    Investigated drugs:
    Belgium Denmark France Germany Italy The Netherlands +1
  • Study on the Effects of Inhaled Treprostinil for Patients with Idiopathic Pulmonary Fibrosis

    Not recruiting

    1 1
    Investigated diseases:
    Investigated drugs:
    Belgium Denmark France Germany Italy The Netherlands +1

Glossary

  • Pulmonary arterial hypertension (PAH): High blood pressure in the arteries of the lungs. It can make the heart work harder and can cause shortness of breath and tiredness.
  • Group I pulmonary arterial hypertension: A specific type of pulmonary hypertension placed in group I. The trial data uses this group to describe the patients in the TripleTRE study.
  • Idiopathic pulmonary fibrosis (IPF): A lung disease that causes scarring in the lungs without a known cause. The scar tissue can make it harder to breathe.
  • Progressive pulmonary fibrosis (PPF): A type of lung scarring that keeps getting worse over time. The trials study whether Treprostinil can slow this worsening.
  • Fibrotic lung disease: A group of lung diseases that cause fibrosis, which means scarring and stiffening of the lungs.
  • Interstitial lung disease (ILD): A group of lung disorders that affect the tissue and space around the air sacs in the lungs. It can reduce breathing ability.
  • Placebo: A treatment that looks like the study medicine but does not contain the active drug. It is used to compare results fairly.
  • Phase 3: A late stage of clinical research. These studies usually include more people and help show whether a treatment works and is safe.
  • FVC: Forced vital capacity. This is the amount of air a person can blow out after taking a deep breath. It is used to check lung function.
  • 6-minute walk distance (6MWD): A test that measures how far a person can walk in 6 minutes. It helps show exercise ability and overall physical function.
  • Clinical worsening: A worsening of the disease that can include death, hospital stay for breathing problems, or a clear decline in lung function.
  • K-BILD score: A questionnaire score that measures how lung disease affects a person's life and breathing-related quality of life.

References