Congenital Heart Disease Clinical Trial
Official title:
Efficacy of Remodulin in Adults With Congenital Heart Disease (ACHD) and Pulmonary Hypertension
The purpose of this study is to evaluate the efficacy of Remodulin in the treatment of adult patients with congenital heart disease and pulmonary hypertension. Baseline and post-treatment cardiopulmonary exercise tests will be performed.
A prospective, open-label, non-randomized multi-center study is proposed to assess the
efficacy of Remodulin in adults with congenital heart disease and pulmonary hypertension.
Subjects will be enrolled at UCLA and Ohio State University (PI: Curt Daniels, MD). The study
will involve a six month trial of continuous subcutaneous Remodulin therapy, with assessments
conducted prior to initiation of therapy and at 1 and 6 months following initiation of
therapy. A separate initiation visit will be scheduled after the baseline visit in order to
provide subjects with comprehensive training in the use and care of the Remodulin drug
delivery system.
Baseline and post-treatment (6 month) assessments will include a history and physical
examination, cardiopulmonary exercise test, six minute walking distance, serum brain
natriuretic peptide (BNP), a Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR)
quality of life survey, and subjective assessment of functional capacity (New York Heart
Association (NYHA) scale). The interim (1 month) follow-up visit will include a thorough
review of adverse events associated with Remodulin therapy, functional class assessment, six
minute walk distance, and serum BNP.
Remodulin will be initiated at 1.25 ng/kg/min and increased by 2-6 ng/kg/min weekly to a
target dose of 40 ng/kg/min. If the initial infusion rate cannot be tolerated it will be
reduced to 0.625 ng/kg/min. Changes in drug dose will be at the discretion of the
investigators following review of interim events. If necessary, the dose may be decreased by
2 ng/kg/min every two days as tolerated.
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