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Treprostinil Palmitil

Phase 3

Pulmonary Arterial Hypertension | Small molecule | Cardiovascular |Insmed Incorporated|Last Updated: Jul 8, 2026

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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials3
Total Enrollment537
FDA Designations
No designations recorded
Clinical trial landscape

Treprostinil Palmitil · 9 trials · 5 indications

Phase 3 3Phase 2 4Phase 1 2
NCT07481981A Study to Evaluate the Efficacy and Safety of Once Daily Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Arterial Hypertension (PAH)Pulmonary Arterial Hypertension
RECRUITING344 Analytics
NCT07234032An Open-Label Extension Study of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Hypertension Associated With Interstitial Lung Disease (PH-ILD)Pulmonary Hypertension
NOT YET_RECRUITING344 Analytics
NCT07179380Efficacy and Safety Study of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Hypertension Associated With Interstitial Lung Disease (PH-ILD)Pulmonary Hypertension
RECRUITING344 Analytics
PHASE3RECRUITING
A Study to Evaluate the Efficacy and Safety of Once Daily Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Arterial Hypertension (PAH)
Pulmonary Arterial HypertensionUnlock trial analytics
PHASE3NOT YET_RECRUITING
An Open-Label Extension Study of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Hypertension Associated With Interstitial Lung Disease (PH-ILD)
Pulmonary HypertensionUnlock trial analytics
PHASE3RECRUITING
Efficacy and Safety Study of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Hypertension Associated With Interstitial Lung Disease (PH-ILD)
Pulmonary HypertensionUnlock trial analytics
Study Endpoints
Primary Endpoints
Change in 6-Minute Walk Distance (6MWD) Measured at 1 to 3 Hours Post-Dose From Baseline at Week 24
Baseline, Week 24
Number of Participants Who Experienced at Least One Treatment-Emergent Adverse Events (TEAEs)
Up to 108 weeks
Change in 6MWD Measured at Peak Exposure From Baseline to Week 24
Baseline, Week 24
Number of Participants Who Experienced a Treatment Emergent Adverse Event (TEAE)
Up to approximately 25 months
Number of Participants Who Experience at Least one Treatment Emergent Adverse Event (TEAE) and TEAEs by Severity
From screening up to last follow up visit (Up to approximately 26 months)
Number of Participants Who Experience Any Number of Treatment Emergent Adverse Events (TEAEs)
Up to Day 140
Number of Participants Who Experience Any Number of Serious Adverse Events (SAEs)
Up to Day 140
Change from Baseline in Saturation of Peripheral Capillary Oxygenation (SpO2) Levels
Pre-, during, and post- 6-minute walk test (6MWT) at Baseline, Week 5, Week 10, and Week 16
Change from Baseline in Pulmonary Vascular Resistance at Week 16
Baseline to Week 16
Area Under the Concentration-Time Curve From Time Zero to Infinity (AUCinf) of Treprostinil Palmitil (TP) and Treprostinil (TRE)
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Area Under the Concentration-Time Curve From Time Zero to Last Quantifiable Concentration (AUClast) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Maximum Observed Plasma Concentration (Cmax) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Apparent Total Clearance (CL/F) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Apparent Terminal Elimination Half-Life (t1/2) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Time to Maximum Observed Concentration (Tmax) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Apparent Volume of Distribution (Vz/F) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Parts A and B: Number of Participants who Experienced an Adverse Event (AE)
Up to Day 31 in Part A and Day 37 in Part B

Safety and tolerability of single and multiple doses of treprostinil inhalation powder will be determined in healthy participants.

Secondary Endpoints
Percentage of Participants With an Improvement From Baseline in World Health Organization (WHO) Functional Class at Week 24
Baseline, Week 24
Change in 6MWD Measured at 24 Hours (±2) Since the Last Dose From Baseline at Week 22
Baseline, Week 22
Change From Baseline in the Concentration of N-Terminal Pro Hormone Brain Natriuretic Peptide (NT-proBNP) at Week 24
Baseline, Week 24
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Study Design & Arms
AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Treprostinil Palmitil Inhalation PowderEXPERIMENTALParticipants will receive TPIP, once daily (QD), at a starting dose of 80 micrograms (μg) up to maximum tolerated dose (up to 1280 μg) for 24 weeks.
PlaceboPLACEBO_COMPARATORParticipants will receive a TPIP-matching placebo, QD, for 24 weeks.
Treprostinil Palmitil Inhalation Powder (TPIP)EXPERIMENTALParticipants transitioning from study INS1009-311 (NCT07179380) will undergo an initial double-dummy titration with the stable dose from the lead-in study and either TPIP or placebo for 4 weeks. They will then receive open-label TPIP at a stable maintenance dose with optional escalation (80-1280 micrograms once daily) for the remainder of the 104-week treatment period.
Treprostinil PalmitilEXPERIMENTALParticipants will be administered TPIP once per day at a starting dose of 80 micrograms (μg). Participants will be titrated up to the highest tolerated dose for each individual participant of between 80 μg and 640 μg during the initial 3 weeks of treatment. The overall treatment period will be 16 weeks.
Group 1: Treprostinil Palmitil Inhalation PowderEXPERIMENTALHealthy participants with normal hepatic function will receive a single dose of TPIP on Day 1.
Group 2: Treprostinil Palmitil Inhalation PowderEXPERIMENTALParticipants with mild hepatic impairment (classified based on the numerical Child-Pugh total score of 5 to 6) will receive a single dose of TPIP on Day 1.
Group 3: Treprostinil Palmitil Inhalation PowderEXPERIMENTALParticipants with moderate hepatic impairment (classified based on the numerical Child-Pugh total score of 7 to 9) will receive a single dose of TPIP on Day 1.
Group 4: Treprostinil Palmitil Inhalation PowderEXPERIMENTALParticipants with severe hepatic impairment (classified based on the numerical Child-Pugh total score of 10 to 15) will receive a single dose of TPIP on Day 1.
Part A (SAD Cohort 1): TPIPEXPERIMENTALParticipants in the single ascending dose (SAD) Cohort 1 received a single dose of TPIP at Dose A, Dose B, or Dose C by oral inhalation on Day 1.
Part A (SAD Cohort 2): TPIP or PlaceboEXPERIMENTALParticipants in SAD Cohort 2 received a single dose of TPIP at Dose D or matching placebo by oral inhalation on Day 1.
Part A (SAD Cohort 3): TPIP or PlaceboEXPERIMENTALParticipants in SAD Cohort 3 received a single dose of TPIP at Dose E or matching placebo by oral inhalation on Day 1.
Part B (MAD Cohort 1): TPIP or PlaceboEXPERIMENTALParticipants in the multiple ascending dose (MAD) Cohort 1 received TPIP at Dose B, Dose C or matching placebo, once daily (QD) by oral inhalation on Days 1 through 7.
Part B (MAD Cohort 2): TPIP or PlaceboEXPERIMENTALParticipants in MAD Cohort 2 received TPIP up to Dose D or matching placebo, QD by oral inhalation on Days 1 through 7.
Interventions
NameTypeDescription
Treprostinil Palmitil Inhalation PowderDRUGOral inhalation using a capsule-based dry powder inhaler device.
PlaceboDRUGOral inhalation using a capsule-based dry powder inhaler device.
Treprostinil PalmitilDRUGAdministered by oral inhalation, using a Plastiape capsule-based dry powder inhaler.
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Eligibility Criteria
Age Range18 Years to 75 Years
SexALL
Healthy VolunteersNo
Study Sites2

Inclusion Criteria * Participants must have a diagnosis of World Health Organisation (WHO) Group 1 pulmonary hypertension (PAH) in any of the following subtypes, in accordance with European Society of Cardiology European Respiratory Society (ESC/ERS) Guidelines: * Idiopathic PAH * Heritable PA...

Countries:United StatesArgentinaAustraliaAustriaBelgiumCzechiaDenmarkFranceGeorgiaGermanyGreeceIsraelItalyJapanMalaysiaNew ZealandPortugalRomaniaSouth KoreaSpainSwitzerlandTaiwanUnited KingdomBrazilMexicoPhilippinesSerbia
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Recent Changes (Last 90 Days)
LOWJul 8, 2026NCT05649748lastUpdatePostDate: changed
LOWJul 8, 2026NCT05649748lastUpdatePostDate: changed
LOWJun 11, 2026NCT07643155NEW_TRIAL: changed
LOWJun 11, 2026NCT07643155NEW_TRIAL: changed
LOWJun 10, 2026NCT07481981lastUpdatePostDate: changed
LOWJun 10, 2026NCT07481981lastUpdatePostDate: changed
LOWMay 29, 2026NCT05649748lastUpdatePostDate: changed
LOWMay 29, 2026NCT05649748lastUpdatePostDate: changed
LOWMay 29, 2026NCT05649748lastUpdatePostDate: changed
LOWMay 28, 2026NCT07179380lastUpdatePostDate: changed
LOWMay 28, 2026NCT07179380lastUpdatePostDate: changed
LOWMay 27, 2026NCT07481981Status: NOT_YET_RECRUITING → RECRUITING
LOWMay 27, 2026NCT07234032startDate: changed
LOWMay 27, 2026NCT07481981Status: NOT_YET_RECRUITING → RECRUITING
LOWMay 27, 2026NCT07234032startDate: changed
MEDIUMMay 26, 2026NCT05649722TRIAL_REMOVED: changed
LOWMay 26, 2026NCT07179380primaryCompletionDate: changed
LOWMay 26, 2026NCT07234032primaryCompletionDate: changed
LOWMay 26, 2026NCT07481981primaryCompletionDate: changed
LOWMay 26, 2026NCT05649748primaryCompletionDate: changed