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NCT01332331

Efficacy and Safety of Ambrisentan in Children 8-18yrs

Terminated Phase 2 Results posted Last updated 8 October 2019
What this trial tests

Phase 2 trial testing Ambrisentan - low dose in Hypertension, Pulmonary in 41 participants. Terminated before completion.

Timeline
4 January 2011
Primary endpoint
12 November 2013
12 November 2013

Quick facts

Lead sponsorGlaxoSmithKline
PhasePhase 2
StatusTerminated
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposetreatment
Enrollment41
Start date4 January 2011
Primary completion12 November 2013
Estimated completion12 November 2013
Sites24 locations across France, Italy, Japan, Russia, Germany, Hungary, Argentina, United States

Drugs / interventions tested

Conditions studied

Sponsor

GlaxoSmithKline — full company profile →

Who can join

Adults 8 to 18, any sex, with Hypertension, Pulmonary. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Participants With Treatment-emergent Adverse Events (AEs) and Serious Treatment-emergent Adverse Events (SAEs) Primary · Up to 24 Weeks

AEs defined as any untoward medical occurrence in a patient or clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. SAEs defined as any untoward medical occurrence that, at any dose results in death, is life threatening, requires hospitalization or prolongation of existing hospitalization, results in disability or incapacity, or is a congenital anomaly or birth defect, medical events that may not immediately life threatening or result in death or hospitalization but may jeopardize the particip

Any AEs
GroupValue95% CI
Low Dose Ambrisentan16
High Dose Ambrisentan16
Any SAEs
GroupValue95% CI
Low Dose Ambrisentan6
High Dose Ambrisentan2
Number of Participants With Post Baseline Potential Clinical Importance (PCI) Value for Clinical Chemistry Parameters: Alanine Amino Transferase (ALT), Aspartate Aminotransferase (AST), Gamma Glutamyl Transferase (GGT), Total Bilirubin and Creatinine Primary · Up to 24 Weeks

Blood samples were collected from participants for analysis of following clinical chemistry parameters: ALT, AST, GGT, total bilirubin and creatinine. PCI ranges were \<3 times the upper limit of normal (ULN), \<34.2 Micromoles per liter (UMOL/L) for total bilirubin and \<176.8 (UMOL/L) for creatinine. Only those parameters having any time post-Baseline PCI values were presented. Day 1 was considered as Baseline.

ALT
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
AST
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
GGT
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Total bilirubin
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan0
Creatinine
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Number of Participants With Post Baseline PCI Value for Hematology Parameter: Hemoglobin Primary · Up to 24 Weeks

Blood samples were collected from participants for analysis of following hematology parameters: hemoglobin. PCI ranges were Males: 98 to180 grams per liter (G/L), Females: 91 to 161 (G/L) for hemoglobin. Only those parameters having any time post-Baseline PCI values were presented. Day 1 was considered as Baseline.

Reference high range
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan2
Reference low range
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan0
Number of Participants With Post Baseline PCI Value for Hematology Parameter: Hematocrit Primary · Up to 24 Weeks

Blood samples were collected from participants for analysis of following hematology parameter: hematocrit. PCI ranges were males: \<0.32 to \>0.54, females: \<0.29 to \>0.506 proportion of red blood cells in blood for hematocrit. Only those parameters having any time post-Baseline PCI values were presented. Day 1 was considered as Baseline.

Reference high range
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan2
Reference low range
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan2
Number of Participants With Post Baseline PCI Value for Hematology Parameter: Platelet Count Primary · Up to 24 Weeks

Blood samples were collected from participants for analysis of following hematology parameter: platelet count. PCI ranges were 100 to 400 for Giga cells per liter platelet count. Only those parameters having any time post-Baseline PCI values were presented. Day 1 was considered as Baseline.

Reference high range
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Reference low range
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan1
Number of Participants With Abnormal Value for Physical Examination Parameter: Liver Size Primary · Week 12 and 24

Physical examination included measurement of liver size. Any abnormal enlargement or reduction in the size of the liver is reported.

Week 12, Abnormal: Improved, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan1
Week 12, Abnormal: Worsened, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan1
Week 12, Abnormal: Unchanged, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan0
Week 24, Abnormal: Improved, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan2
High Dose Ambrisentan1
Week 24, Abnormal: Worsened, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Week 24, Abnormal: Unchanged, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Number of Participants With Abnormal Value for Physical Examination Parameter: Jugular Venous Pressure Primary · Week 12 and 24

Physical examination of participants jugular venous pressure is measured.

Week 12, Abnormal: Improved, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan1
Week 12, Abnormal: Worsened, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan1
Week 12, Abnormal: Unchanged, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan3
Week 24, Abnormal: Improved, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan1
Week 24, Abnormal: Worsened, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan0
Week 24, Abnormal: Unchanged, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan4
Number of Participants With Abnormal Value for Physical Examination Parameter: Peripheral Edema Primary · Week 12 and 24

Physical examination of paricipants peripheral edema is measured. Day 1 was considered as Baseline.

Week 12, Abnormal: Improved, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Week 12, Abnormal: Worsened, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan1
Week 12, Abnormal: Unchanged, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan1
Week 24, Abnormal: Improved, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan0
Week 24, Abnormal: Worsened, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan0
Week 24, Abnormal: Unchanged, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Number of Participants With Abnormal Value for Physical Examination Parameter: Ascites Primary · Week 12 and 24

Physcial examination of paricipants ascites was measured. Day 1 was considered as Baseline.

Week 12, Abnormal: Improved, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Week 12, Abnormal: Worsened, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Week 12, Abnormal: Unchanged, n=20, 19
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Week 24, Abnormal: Improved, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Week 24, Abnormal: Worsened, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Week 24, Abnormal: Unchanged, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Percentage of Physical Examination Parameter: Saturated Oxygen Level Primary · Week 12 and 24

Physical examination of participants saturated oxygen level was measured. Day 1 was considered as Baseline.

Week 12, n=20, 18
GroupValue95% CI
Low Dose Ambrisentan96.9± 2.59
High Dose Ambrisentan96.9± 6.93
Week 24, n=19, 18
GroupValue95% CI
Low Dose Ambrisentan97.3± 1.85
High Dose Ambrisentan97.4± 1.92
Number of Participants With Post Baseline PCI Value for Vital Signs Parameter: Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) Primary · Up to 24 Weeks

SBP and DBP were measured in semi-supine position after 5 minutes rest for the participants at indicated time points. PCI ranges were \<80 to \>160 millimeters of mercury (mmHg) for SDP and \<40 to \>110 mmHg for DBP. Only those parameters having any time post-Baseline PCI values were presented. Day 1 was considered as Baseline.

SBP, Reference range high
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
SBP, Reference range low
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan2
DBP, Reference range high
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
DBP, Reference range low
GroupValue95% CI
Low Dose Ambrisentan0
High Dose Ambrisentan0
Number of Participants With Post Baseline PCI Value for Vital Signs Parameter: Heart Rate Primary · Up to 24 Weeks

Heart rate was measured in semi-supine position after 5 minutes rest for the participants at indicated time points. PCI ranges were \<50 to \>120 beats per minute (beats/min). Only those parameters having any time post-Baseline PCI values were presented. Day 1 was considered as Baseline.

Reference range high
GroupValue95% CI
Low Dose Ambrisentan2
High Dose Ambrisentan2
Reference range low
GroupValue95% CI
Low Dose Ambrisentan1
High Dose Ambrisentan0

Adverse events — posted to ClinicalTrials.gov

Time frame: On-treatment serious adverse events (SAEs) and non serious AEs were collected from the start of study treatment up to 24 weeks. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Low Dose Ambrisentan
Serious: 6/21 (29%)
Deaths: 1/21
High Dose Ambrisentan
Serious: 2/20 (10%)
Deaths: 0/20

Serious adverse events (9 terms)

ReactionSystemLow Dose AmbrisentanHigh Dose Ambrisentan
Cardiac failure acuteCardiac disorders
Right ventricular failureCardiac disorders
General physical health deteriorationGeneral disorders
Device related infectionInfections and infestations
PharyngitisInfections and infestations
PneumoniaInfections and infestations
SyncopeNervous system disorders
Device breakageProduct Issues
Pulmonary hypertensionRespiratory, thoracic and mediastinal disorders
Other adverse events (45 terms — click to expand)

ReactionSystemLow Dose AmbrisentanHigh Dose Ambrisentan
HeadacheNervous system disorders
Abdominal painGastrointestinal disorders
NauseaGastrointestinal disorders
Abdominal pain upperGastrointestinal disorders
NasopharyngitisInfections and infestations
Upper respiratory tract infectionInfections and infestations
DiarrhoeaGastrointestinal disorders
VomitingGastrointestinal disorders
Face oedemaGeneral disorders
PyrexiaGeneral disorders
Oedema peripheralGeneral disorders
GastroenteritisInfections and infestations
LaryngitisInfections and infestations
PharyngitisInfections and infestations
PneumoniaInfections and infestations
Back painMusculoskeletal and connective tissue disorders
Pain in extremityMusculoskeletal and connective tissue disorders
Nasal congestionRespiratory, thoracic and mediastinal disorders
ErythemaSkin and subcutaneous tissue disorders
Heparin-induced thrombocytopeniaBlood and lymphatic system disorders
LymphopeniaBlood and lymphatic system disorders
NeutropeniaBlood and lymphatic system disorders
CyanosisCardiac disorders
PalpitationsCardiac disorders
Dry mouthGastrointestinal disorders
GastritisGastrointestinal disorders
AstheniaGeneral disorders
FatigueGeneral disorders
HepatomegalyHepatobiliary disorders
Ear infectionInfections and infestations
Gastroenteritis viralInfections and infestations
Respiratory tract infectionInfections and infestations
Viral upper respiratory tract infectionInfections and infestations
Joint injuryInjury, poisoning and procedural complications
Limb injuryInjury, poisoning and procedural complications
Toxicity to various agentsInjury, poisoning and procedural complications
International normalised ratio increasedInvestigations
HypokalaemiaMetabolism and nutrition disorders
MyalgiaMusculoskeletal and connective tissue disorders
Neck painMusculoskeletal and connective tissue disorders

Most-reported serious reactions: Cardiac failure acute, Right ventricular failure, General physical health deterioration, Device related infection, Pharyngitis, Pneumonia, Syncope, Device breakage.

Data from ClinicalTrials.gov NCT01332331 adverse events section.

Sponsor's own description

A 6-month (24-week), randomized, open label evaluation of the safety, tolerability, and efficacy of a high and low dose ambrisentan (adjusted for body weight) treatment group in subjects aged 8 years up to 18 years with pulmonary arterial hypertension (PAH). An additional objective is to determine the ambrisentan population pharmacokinetics in the paediatric population. The study will include a screening/baseline period and a treatment period. The treatment period will be 24 weeks or until the subject's clinical condition deteriorates to the point that alternative/additional treatment is necessary. Patients who participate in the study and in whom continued treatment with ambrisentan is desired will be eligible to enrol into a long term follow-up study. The primary comparison will be the safety and tolerability of the two ambrisentan dose groups (Low vs. High) in the paediatric PAH population The secondary comparison will be the change from baseline for the efficacy parameters between the two treatment groups.

Publications & conference data

4 peer-reviewed publications reference this trial (live from Europe PMC):

  1. A Randomized Study of Safety and Efficacy of Two Doses of Ambrisentan to Treat Pulmonary Arterial Hypertension in Pediatric Patients Aged 8 Years up to 18 Years.
    Ivy D, Beghetti M, Juaneda-Simian E, Miller D, et al · · 2020 · cited 6× · PMID 37332660 · DOI 10.1016/j.ympdx.2020.100055
  2. Long-term safety and tolerability of ambrisentan treatment for pediatric patients with pulmonary arterial hypertension: An open-label extension study.
    Ivy D, Beghetti M, Juaneda-Simian E, Ravindranath R, et al · · 2024 · cited 2× · PMID 38366267 · DOI 10.1007/s00431-024-05446-1
  3. Pediatric Population Pharmacokinetic Modeling and Exposure-Response Analysis of Ambrisentan in Pulmonary Arterial Hypertension and Comparison With Adult Data.
    Okour M, Thapar MM, Farrell C, Lukas MA, et al · · 2023 · cited 2× · PMID 36579617 · DOI 10.1002/jcph.2199
  4. Paediatric population pharmacokinetic and pharmacodynamic modelling of ambrisentan in pulmonary arterial hypertension and comparison with adult data
    Okour M, Thapar M, Farrell C, Lukas MA, et al · · 2021 · DOI 10.22541/au.162191011.16279819/v1

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing