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Treprostinil diethanolamine

Phase 4

Systemic Sclerosis | Small molecule | Immunology |United Therapeutics Corporation|Trials Updated: Jan 3, 2024

Treprostinil diethanolamine development status

Highest phase Phase 4 (NCT05203510)
Phase scored for UTHRPhase 2
Registered trials 30 across 3 sponsors since May 2006

Treprostinil diethanolamine target and mechanism

Molecular targetPTGIR
Target classAgonist
ModalitySmall molecule

Also known as UT-15C, UT-15C SR, Oral treprostinil, Treprostinil diolamine, Oral treprostinil (UT-15C) Sustained Release Tablets

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials15
Total Enrollment1,963

FDA Designations

No designations recorded

Treprostinil diethanolamine clinical trials

Treprostinil diethanolamine · 15 trials · 6 indications

Phase 3 4Phase 2 4Phase 1 7
NCT01560637An Open-Label, Long-Term Study of Oral Treprostinil in Subjects With Pulmonary Arterial HypertensionPulmonary Arterial Hypertension
COMPLETED471 Analytics
NCT01934582A Pharmacokinetic Substudy of the TDE-PH-304 ProtocolPulmonary Arterial Hypertension
COMPLETED13 Analytics
NCT01560624Phase III Clinical Worsening Study of UT-15C in Subjects With PAH Receiving Background Oral MonotherapyPulmonary Arterial Hypertension
COMPLETED690 Analytics
NCT00887978Efficacy and Safety of Oral UT-15C Tablets to Treat Pulmonary Arterial HypertensionPulmonary Hypertension
COMPLETED310 Analytics
PHASE3COMPLETED
An Open-Label, Long-Term Study of Oral Treprostinil in Subjects With Pulmonary Arterial Hypertension
Pulmonary Arterial HypertensionUnlock trial analytics
PHASE3COMPLETED
A Pharmacokinetic Substudy of the TDE-PH-304 Protocol
Pulmonary Arterial HypertensionUnlock trial analytics
PHASE3COMPLETED
Phase III Clinical Worsening Study of UT-15C in Subjects With PAH Receiving Background Oral Monotherapy
Pulmonary Arterial HypertensionUnlock trial analytics
PHASE3COMPLETED
Efficacy and Safety of Oral UT-15C Tablets to Treat Pulmonary Arterial Hypertension
Pulmonary HypertensionUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Adverse Events
Participants will be followed every 12 weeks, at minimum, until they discontinue the study or the study is discontinued by the sponsor or for a period up to 2.5 years

All subjects who received oral treprostinil in TDE-PH-311 were included in the Safety population. All AEs were captured from the time the ICF was signed. All AEs were followed until resolution (or return to normal or baseline values), until they were judged by the Investigator to no longer be clinically significant, or for up to 30 days if the AE extended beyond the final visit. All SAEs were followed until resolution, death, or the subject was lost to follow-up, even if they were ongoing more than 30 days after completion of the final visit. The overall summary of AEs includes the number of subjects with any AE, the number of subjects with any study drug-related AEs, the number of subjects with AEs leading to study drug withdrawal, the number of subjects with any serious AEs, the number of subjects with any severe AEs, and the number of subjects with any study drug-related severe/serious AEs. AEs were coded using the Medical Dictionary for Regulatory Activities.

To Assess the Pharmacokinetics (Mean AM Dose) in Subjects During Twice Daily (BID) Dosing (up to 14 Days Prior to Transitioning to Three Times Daily [TID] Dosing Regimen at PK Visit 1) and up to 35 Days After Transitioning to TID Dosing (at PK Visit 2).
Up to 14 days prior to transitioning to TID dosing regimen (PK Visit 1) and up to 35 days after transitioning to TID dosing regiment (PK Visit 2)

The PK sampling occurred over a 12-hour period in subjects during BID dosing (PK Visit 1) and during TID dosing (PK Visit 2). Prior to each PK sampling day, subjects must have been receiving a stable dose for at least 5 days.

To Assess the Pharmacokinetics (Cmax, Cmin) in Subjects During BID Dosing (up to 14 Days Prior to Transitioning to TID Dosing Regimen at PK Visit 1) and up to 35 Days After Transitioning to TID Dosing Regiment (PK Visit 2)
Up to 14 days prior to transitioning to TID dosing regimen (PK Visit 1) and up to 35 days after transitioning to TID dosing regiment (PK Visit 2)

The PK sampling occurred over a 12-hour period in subjects during BID dosing (PK Visit 1) and during TID dosing (PK Visit 2). Prior to each PK sampling day, subjects must have been receiving a stable dose for at least 5 days.

To Assess the Pharmacokinetics (AUClast) in Subjects During Twice Daily (BID) Dosing (up to 14 Days Prior to Transitioning to Three Times Daily [TID] Dosing Regimen at PK Visit 1) and up to 35 Days After Transitioning to TID Dosing (at PK Visit 2).
0, 1, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96 hours post-dose at up to 14 days prior to transitioning to TID dosing regimen (PK Visit 1) and at up to 35 days after transitioning to TID dosing regiment (PK Visit 2)

The PK sampling occurred over a 12-hour period in subjects during BID dosing (PK Visit 1) and during TID dosing (PK Visit 2). Prior to each PK sampling day, subjects must have been receiving a stable dose for at least 5 days.

Time to First Clinical Worsening Event
From randomization to approximately 4 years

Clinical worsening was assessed continuously from randomization until the subject's last study visit. Clinical worsening events were defined as death (all causes), hospitalizations due to worsening pulmonary arterial hypertension (PAH), initiation of an inhaled or infused prostacyclin (PGI2) for the treatment of worsening PAH, disease progression, or unsatisfactory long-term clinical response. All clinical worsening events reported by the study sites were reviewed by the Sponsor Medical Monitors. Once a clinical worsening event occurred, it was entered in the eCRF and a narrative was submitted for review by the Sponsor's Medical Monitor within 48 hours after the event became known to the Investigator or designee. Subsequently, the narratives for subjects with the reported clinical worsening events were sent to an independent adjudication committee. The independent adjudication committee reviewed and adjudicated all clinical worsening events throughout the study.

6-minute Walk Distance (6MWD)
Baseline and 16 weeks

Placebo-corrected change in 6MWD from Baseline to Week 16, correlates with the current clinical standard for assessing patient functional status in the treatment of PAH and is considered an objective measure of patient functional status by the American Thoracic Society (ATS). The 6MWD was to be assessed between 3 and 6 hours after the morning dose of study drug and background therapy(ies).

Number of Participants That Were Succesfully Transitioned From Parenteral Remodulin to UT-15C.
Up to 24 weeks

Successful transition was based on the number of participants that completely transitioned to oral treprostinil by the week 4 study visit and clinically maintained on oral treprostinil treatment through Week 24.

Change in Hemodynamic Parameters From Baseline to Week 24.
Baseline and Week 24

Hemodynamics (via right heart catheterization \[RHC\]) were assessed at Baseline and Week 24 or at the time of premature termination of study drug if prior to the Week 24 visit. Cardiopulmonary hemodynamic measurements included the following: mean pulmonary arterial pressure (PAPm), mean systemic arterial pressure (SAPm), mean right atrial pressure (RAPm), and mean pulmonary capillary wedge pressure (PCWPm).

Change in Hemodynamic Parameter (Heart Rate) From Baseline to Week 24.
Baseline and Week 24

Heart rate was assessed at Baseline and Week 24 or at the time of premature termination of study drug if prior to the Week 24 visit.

Change in Hemodynamic Parameters (Arterial and Venous Oxygen Saturation) From Baseline to Week 24.
Baseline and Week 24

Hemodynamics (via right heart catheterization \[RHC\]) were assessed at Baseline and Week 24 or at the time of premature termination of study drug if prior to the Week 24 visit. Cardiopulmonary hemodynamic measurements included arterial oxygen saturation (SaO2) and mixed venous oxygen saturation (SvO2).

Change in Hemodynamic Parameter (Cardiac Output) From Baseline to Week 24.
Baseline and Week 24

Hemodynamics (via right heart catheterization \[RHC\]) were assessed at Baseline and Week 24 or at the time of premature termination of study drug if prior to the Week 24 visit.

Change in Hemodynamic Parameter (Cardiac Index) From Baseline to Week 24.
Baseline and Week 24

Hemodynamics (via right heart catheterization \[RHC\]) were assessed at Baseline and Week 24 or at the time of premature termination of study drug if prior to the Week 24 visit. Cardiopulmonary hemodynamic measurements included cardiac index (CI).

Change in Hemodynamic Parameter (Pulmonary Vascular Resistance Index) From Baseline to Week 24.
Baseline and Week 24

Hemodynamics (via right heart catheterization \[RHC\]) were assessed at Baseline and Week 24 or at the time of premature termination of study drug if prior to the Week 24 visit. Cardiopulmonary hemodynamic measurements included the following: pulmonary vascular resistance index (PVRI).

Change in Peak Total Pulmonary Resistance Index (TPRI) During Exercise From Baseline to Week 12
Baseline and Week 12

The effects of 12-week treatment with different doses of UT-15C on peak TPRI during exercise will be evaluated by comparing the change from Baseline to Week 12 at peak wattage on a pairwise basis between treatment groups. The primary measure of efficacy was the change from Baseline to Week 12 in peak TPRI during exercise assessed 3 to 6 hours after the subject's morning dose of UT-15C to obtain measurements at peak concentrations of treprostinil. The equation used to determine the Total Pulmonary Resistance Index (TPRI) (mmHg/\[L/min/m\^2\]) is Mean Pulmonary Artery Pressure (PAPm)/ Cardiac Index (CI).

Net Ulcer Burden
Week 20

Net ulcer burden was defined as the number of "new" or "active" digital ulcers (DU), plus the number of "indeterminate" DUs at that assessment that have previously been classified as either "active" or "new" at any earlier assessment during the study. A DU was defined as an area with visually discernable depth and a loss of continuity of epithelial coverage, which could be denuded or covered by a scab or necrotic tissue. If denuded, the DU was pronounced "active." If denudation could not be judged because of the presence of scab or necrotic tissue, DU presenting with features, including underlying pain, based on Investigator clinical judgment to be consistent with loss of epithelialization, epidermis, or dermis, and requiring treatment were designated as "active." Otherwise, the DU was pronounced "indeterminate." Only DUs distal to the proximal interphalangeal joints, volar to the equator of the finger, not localized in creases and vascular in origin were assessed.

Plasma treprostinil concentrations
1 month

Pharmacokinetic blood sampling will occur twice for each subject. Pharmacokinetic parameters will be derived from treprostinil concentration-time data

Treprostinil pharmacokinetics
36 hours

Treprostinil pharmacokinetics in healthy volunteers following a single oral dose of 0.5 mg, 1 mg and 2.5 mg treprostinil diethanolamine sustained release tablets immediately prior to through 36 hours post treprostinil diethanolamine dosing.

Treprostinil pharmacokinetics in volunteers with varying degrees of renal function following a single oral dose of a 1 mg treprostinil diethanolamine sustained release.
48hrs post dose (60 hours for ESRD)
Treprostinil pharmacokinetics in healthy volunteers following a single oral dose of a 1 mg treprostinil diethanolamine sustained release tablet after four different meal types.
Immediately prior to through 36 hours post treprostinil diethanolamine dosing for each treatment period (4 treatment periods each separated by a 7-day washout period)
Adverse event monitoring
From the first dose of treprostinil diethanolamine through study end (Study Day 23/24)
Treprostinil pharmacokinetics in healthy volunteers following a single oral dose of a 1 mg treprostinil diethanolamine sustained release tablet before and after repeated dosing with esomeprazole.
Within 10 minutes prior to through 36 hours post treprostinil diethanolamine dosing
Cohort 1: treprostinil pharmacokinetics in patients with systemic sclerosis following single oral administration of a 1 mg treprostinil diethanolamine SR dose.
pre-24hrs post dose
Cohort 2: treprostinil pharmacokinetics at dose levels of 2 mg BID and 4 mg BID, respectively, in patients with systemic sclerosis following repeated oral administration of treprostinil diethanolamine SR tablets
0-12 hrs post-dose

Secondary Endpoints

Change in 6-Minute Walk Distance From Baseline
Baseline to Week 48
Change in Borg Dyspnea Score From Baseline to Week 48
Baseline to Week 48
Change From Baseline to Week 48 in WHO Functional Class
Baseline to Week 48
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
UT-15CEXPERIMENTALOpen label access
Open label extensionEXPERIMENTAL -
PlaceboPLACEBO_COMPARATORMatching placebo tablets (oral)
UT-15C SREXPERIMENTALDoses were initiated at 0.25 mg BID and increased by 0.25 mg BID every three days (as clinically indicated based on tolerability and symptoms of PAH), to a max dose of 16 mg BID.
UT-15C SR BIDEXPERIMENTALInitiated at 0.125 mg twice daily (BID), titrated as clinically indicated.
Dose Group 1ACTIVE_COMPARATORUT-15C 0.25 mg twice daily
Dose Group 2ACTIVE_COMPARATORUT-15C 1.25 mg twice daily
Dose Group 3ACTIVE_COMPARATORUT-15C individual Maximum Tolerated Dose
treprostinil diethanolamineEXPERIMENTALTreprostinil diethanolamine sustained release tablet initiated at 0.25 mg BID and titrated up to a maximum dose of 16 mg BID or the individual's maximum tolerated dose.
placebo (sugar pill)PLACEBO_COMPARATORMatching placebo sustained release tablet initiated at 0.25 mg BID and titrated up to a maximum dose of 16 mg BID or the individual's maximum tolerated dose.
1 mg tablet; 1mg solutionEXPERIMENTAL -
1mg solution; 1mg tabletEXPERIMENTAL -
0.5 mg treprostinil diethanolamineEXPERIMENTAL0.5 mg treprostinil diethanolamine
2.5 mg treprostinil diethanolamineEXPERIMENTAL2.5 mg treprostinil diethanolamine
1 mg treprostinil diethanolamineEXPERIMENTAL1 mg treprostinil diethanolamine
manufacturer #1ACTIVE_COMPARATORtreprostinil diethanolamine from manufacturer #1
manufacturer #2EXPERIMENTALtreprostinil diethanolamine from manufacturer #2

Interventions

NameTypeDescription
UT-15C (treprostinil diolamine)DRUGUT-15C extended release oral tablet three times daily
UT-15C SRDRUG -
treprostinil diethanolamineDRUGOpen label study drug.
Treprostinil DiolamineDRUGActive
PlaceboDRUGPlacebo
Tyvaso Inhalation SolutionDRUGAdministered as at least 9 breaths 4 times daily for at least 4 weeks prior to Baseline
UT-15CDRUGoral
UT-15C SR (treprostinil diethanolamine)DRUGSingle dose, 1 mg UT-15C SR
Standardized mealsOTHEREach subject will receive one of four different standardized meals of varying caloric and fat content in a randomized sequence such that all subjects will receive all four meals over the course of the study. Each subject will receive one standardized meal for breakfast on Study Days 1, 8, 15, and 22.
EsomeprazoleDRUGEach subject will receive a single 40 mg capsule of esomeprazole by mouth in the morning for seven days.
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Eligibility Criteria

Age Range18 Years to 75 Years
SexALL
Healthy VolunteersNo
Study Sites153

Inclusion Criteria: * Participated in United Therapeutics Study TDE-PH-310 * All women of childbearing potential (WOCBP) must have practiced true abstinence from intercourse when it was in line with their preferred and usual lifestyle or used 2 different forms of highly effective contraception for ...

Countries:United StatesArgentinaAustraliaAustriaBrazilCanadaChileChinaDenmarkFranceGermanyGreeceIndiaIsraelItalyMexicoNetherlandsPolandSingaporeSouth KoreaSwedenTaiwanUnited KingdomBelgiumPortugalSpain
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Frequently asked questions about Treprostinil diethanolamine

What is treprostinil diethanolamine?

Treprostinil diethanolamine is an oral small molecule developed by United Therapeutics Corporation for pulmonary arterial hypertension and related cardiovascular conditions. It is an investigational agent that has been studied in Phase 1 clinical trials, primarily to characterize its bioavailability and pharmacokinetic profile in healthy volunteers.

What does treprostinil diethanolamine target?

Treprostinil diethanolamine targets PTGIR, the prostacyclin receptor, where it acts as an agonist. Agonism at this receptor supports vasodilation relevant to pulmonary arterial hypertension. This mechanism aligns with the drug's development for pulmonary vascular and systemic sclerosis related indications.

Who makes treprostinil diethanolamine?

United Therapeutics Corporation develops treprostinil diethanolamine. The company trades on the Nasdaq under the ticker UTHR. United Therapeutics has sponsored the Phase 1 clinical program evaluating oral formulations of this compound.

What phase is treprostinil diethanolamine in?

Treprostinil diethanolamine is in Phase 1 clinical development. It is investigational and has not been approved by the FDA. The completed Phase 1 studies focused on bioavailability, pharmacokinetic linearity, and drug interaction assessments rather than pivotal efficacy endpoints.

What clinical trials is treprostinil diethanolamine in?

Four completed Phase 1 trials have evaluated treprostinil diethanolamine: NCT01172496, NCT01165476, NCT01153386, and NCT00963027. These studies enrolled 154 participants in total and examined oral tablet and solution bioavailability, manufacturing comparability, pharmacokinetic linearity, and the effect of esomeprazole on oral treprostinil pharmacokinetics.

What is treprostinil diethanolamine used for in pulmonary arterial hypertension?

Treprostinil diethanolamine has been studied in pulmonary arterial hypertension as an oral prostacyclin receptor agonist. The Phase 1 trials were conducted in healthy volunteers to assess bioavailability and pharmacokinetics rather than to establish efficacy in patients. It remains investigational for this indication.