Status:

COMPLETED

A Study of the Efficacy and Safety of Frespaciguat (MK-5475) in Participants With Pulmonary Arterial Hypertension (INSIGNIA-PAH: Phase 2/3 Study of an Inhaled sGC Stimulator in PAH) (MK-5475-007)

Lead Sponsor:

Merck Sharp & Dohme LLC

Conditions:

Pulmonary Arterial Hypertension

Hypertension, Pulmonary

Eligibility:

All Genders

18-75 years

Phase:

PHASE2

PHASE3

Brief Summary

This is a two-part (Phase 2/Phase 3) study of frespaciguat, an inhaled soluble guanylate cyclase stimulator, in participants with pulmonary arterial hypertension (PAH). The first part (Phase 2) will ...

Eligibility Criteria

Inclusion

  • Pulmonary arterial hypertension (PAH) in one of the following groups:
  • Idiopathic PAH
  • Heritable PAH
  • Drug and toxin-induced PAH
  • PAH associated with connective tissue disease, HIV infection, or congenital heart disease.
  • Diagnosis of PAH documented by right heart catheterization (RHC).
  • Eligibility RHC meeting all of the following criteria:
  • Mean pulmonary artery pressure (mPAP) ≥25 mmHg
  • Pulmonary vascular resistance (PVR) of ≥3 Wood units
  • Pulmonary capillary wedge pressure (PCWP) or left ventricular end diastolic pressure (LVEDP) ≤15 mmHg.
  • World Health Organization functional class (WHO-FC) symptoms between Class II and IV.
  • Two 6-Minute walk distance (6MWD) measurements between 150 and 500 meters, one at screening and one at randomization.
  • Stable concomitant background PAH-specific therapy.
  • Body Mass Index (BMI) between 18.5 kg/m² and 40 kg/m² .
  • Agree to be abstinent from heterosexual intercourse or use contraception during the intervention period and for at least 14 days after the last dose of study intervention.
  • Female participants may not be pregnant or breastfeeding.

Exclusion

  • Group 2 to 5 pulmonary hypertension.
  • PAH in one of the following groups:
  • Long term responders to calcium channel blockers
  • Overt features of venous/capillary involvement
  • Evidence of more-than-mild obstructive lung disease.
  • Evidence of more-than-mild parenchymal lung disease.
  • Evidence of more-than-mild obstructive sleep apnea (OSA) that is untreated.
  • Evidence or history of left heart disease, including any of the following:
  • Left ventricular ejection fraction (LVEF) ≤45%
  • Moderate or severe left-sided valvular disease (aortic or mitral valve stenosis or regurgitation)
  • Significant left ventricular diastolic dysfunction on echocardiographic evaluation
  • Presence of 3 or more of the following risk factors for heart failure with preserved ejection fraction: BMI\>30 kg/m², essential systemic hypertension, diabetes mellitus of any type, or coronary artery disease.
  • Oxygen saturation measured by pulse oximetry (SpO₂) \<90%, despite supplemental oxygen therapy.
  • Chronic renal insufficiency (eGFR \<30 mL/min)
  • Chronic liver disease (i.e., Child-Pugh B or C), portal hypertension, cirrhosis, or significant hepatic laboratory abnormalities.
  • Current smoker or currently uses electronic cigarettes (vapes).
  • History of cancer, except: nonmelanomatous skin carcinoma or carcinoma in situ of the cervix or other malignancies which have been successfully treated, with appropriate follow up, and unlikely to recur for the duration of the study.

Key Trial Info

Start Date :

May 19 2021

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

July 2 2024

Estimated Enrollment :

168 Patients enrolled

Trial Details

Trial ID

NCT04732221

Start Date

May 19 2021

End Date

July 2 2024

Last Update

May 25 2025

Active Locations (91)

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Page 1 of 23 (91 locations)

1

University of California San Diego Health-Pulmonary Critical Care ( Site 0061)

La Jolla, California, United States, 92037-7381

2

University of California Davis Health-Internal Medicine: Pulmonary, Critical Care and Sleep Medicine

Sacramento, California, United States, 95817

3

UCSF Helen Diller Medical Center at Parnassus Heights ( Site 0063)

San Francisco, California, United States, 94143

4

University of Colorado - Denver ( Site 0003)

Aurora, Colorado, United States, 80045