View Clinical Trial (Medical Research Study)
The Effect of Bosentan and Pioglitazone on Insulin Resistance in Pulmonary Arterial Hypertension
| City: |
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Stanford |
| State: |
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California |
| Zip Code: |
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94305 |
| Conditions: |
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Hypertension, Pulmonary |
| Purpose: |
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The purpose of this study is to evaluate 1) the incidence of insulin resistance (a
pre-diabetic state) in patients with pulmonary hypertension, and 2) test the utility of a
validated PH therapy (Tracleer) versus Pioglitazone in the treatment of those patients found
to have insulin resistance.
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| Study Summary: |
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| Criteria: |
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Inclusion Criteria:
Patients with PAH must be stable on therapy for at least 3 months prior to enrollment in
the trial. We will include patients with IPAH and FPAH as well as PAH associated with
collagen vascular disease or drug or toxin exposure. With the exception of PAH, subjects
must be free of major medical illnesses, including diabetes mellitus (must have fasting
plasma glucose < 126 mg/dL and taking no anti-hyperglycemic agent), malignancy or
significant hepatic or renal disease. Subjects may be hypertensive and on
anti-hypertensive medications as long as blood pressure is < 150/100 mm Hg. Subjects may
also be dyslipidemic and/or taking drugs to improve abnormalities of lipid metabolism, but
they will be excluded if they are taking medications known to alter insulin sensitivity,
including glucocorticoids, niacin, anti-retrovirals, thiazolidinediones, or metformin. Use
of oral contraceptives or estrogen and/or progesterone replacement therapy is permitted.
Weight must be stable and the subjects agree not to change their eating habits or exercise
regimen during the study period. There will be no restrictions with regard to race or
socioeconomic status, and the racial/ethnic composition of the study population will be
reflective of the communities surrounding the Stanford University Medical Center.
Exclusion Criteria:
* Vulnerable subject status.
- Concurrent ET-1 antagonist therapy
- Concurrent Thiazolidinedione therapy
- New York Heart Class III or IV
- PAH related to other etiologies.
- Diabetes Mellitus with Fasting Glucose Levels > 126 mg/dL
- Allergy or hypersensitivity to pioglitazone or bosentan administration.
- Current treatment with statin therapy.
- Initiation of PAH therapy (prostacyclin analogues, phosphodiesterase-5 inhibitors)
within three months of enrollment.
- Inability or unwillingness to avoid systemic steroid containing medications for four
months. Inhaled steroid use is acceptable.
- Current or recent use or planned treatment with: glyburide, cyclosporine, nilotinib,
nisoldipine, ranolazine, thioridazine
- Hepatic transaminases > 2x the upper limit of normal at the center at screening.
- Current or recent (< 6 months) chronic heavy alcohol consumption.
- Current use of another investigational drug (non-FDA approved) for PAH.
- Lung transplant recipients.
- History of myositis.
- Renal failure (Cr 2.0).
- Hospitalized or acutely ill.
- Chronic liver disease (cirrhosis, chronic hepatitis, etc.).
- Abnormalities of the arm or hand or radical mastectomy (preventing brachial artery
ultrasound).
- Pregnant or lactating women.
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| NCT ID: |
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NCT00825266 |
| Primary Contact: |
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Principal Investigator
Roham T. Zamanian
Stanford University
Roham Zamanian
Phone: (650) 725-5495
Email: zamanian@stanford.edu
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| Backup Contact: |
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N/A |
| Location Contact: |
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Stanford, California 94305
United States
Roham Zamanian
Phone: 650-725-5495
Email: zamanian@stanford.edu
Site Status: Recruiting |
| Data Source: |
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ClinicalTrials.gov |
| Date Processed: |
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May 22, 2013 |
| Modifications to this listing: |
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