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A Randomized Control Trial to Assess the Efficacy of Tadalafil in Raynaud's Phenomenon in Scleroderma

Information source: Sanjay Gandhi Postgraduate Institute of Medical Sciences
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Raynaud's Phenomenon; Digital Ulcers; Scleroderma

Intervention: Tadalafil (Drug); Placebo (Drug)

Phase: Phase 3

Status: Completed

Sponsored by: Sanjay Gandhi Postgraduate Institute of Medical Sciences

Official(s) and/or principal investigator(s):
Parasar Ghosh, MD, DM, Principal Investigator, Affiliation: IPGMER, Kolkatta
Aman Sharma, MD, Principal Investigator, Affiliation: PGIMER, Chandigarh
Darshan S Bhakuni, MD, Principal Investigator, Affiliation: Army R&R Hospital, New Delhi

Summary

Raynaud's phenomenon (RP) associated with scleroderma is a difficult problem to treat. Many patients develop ischemic digital ulcers due to severe RP that causes considerable morbidity and adversely affects the quality of life. In an earlier study, we have observed marked improvement in RP attacks and rapid healing of digital ulcers following therapy with phosphodiesterase V inhibitor, Tadalafil. In the present multicentric study we aim to study the efficacy of Tadalafil in patients continuing to have RP attacks despite using at least one or more vasodilators.

Clinical Details

Official title: A Randomized Control Trial to Assess the Efficacy of Tadalafil in Raynaud's Phenomenon in Scleroderma: A Double Blind, Parallel Group, Multicentric Study

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Primary outcome:

Daily frequency, duration and severity of Raynaud's phenomenon

Appearance or healing of digital ulcers

Secondary outcome:

Improvement in health assessment questionnaire

Improvement in scleroderma specific health assessment questionnaire

Improvement in quality of life

Improvement in biomarkers of endothelial dysfunction

Improvement in flow mediated dilatation

Eligibility

Minimum age: 18 Years. Maximum age: 65 Years. Gender(s): Both.

Criteria:

Inclusion Criteria: Male or female subjects between the ages of 18 years and 65 years will be selected for the study if they have a clinical diagnosis of Raynaud's phenomenon secondary to systemic sclerosis (scleroderma) despite being on vasodilator therapy. Raynaud's phenomenon is defined as a history of cold sensitivity associated with colour changes of cyanosis or pallor. Patients with a history of at least 4 attacks per week during two-week pre-trial period even with treatment with other vasodilators will be recruited. Patients fulfilling the diagnostic criteria of scleroderma (as per American College of Rheumatology criteria) or having presence of at least 3 of the 5 features of the CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias)will be invited to participate in the study. Exclusion Criteria: Patients with:

- Symptomatic orthostatic hypotension,

- Evidence of current malignancy,

- History of sympathectomy,

- Upper extremity deep vein thrombosis or lymphedema within 3 months,

- Recent surgical procedure requiring general anesthesia,

- Acute Myocardial Infarction, unstable angina, strokes and transient ischemic attacks

within the past three months,

- Smoking,

- Use of any investigational drug within 30 days of the study sessions,

- Use of medications that might interfere with tadalafil like nitrates and alpha

adrenergic blockers that have vasoactive effects, and patients taking potent inhibitors of CYP3A4 such as ritonavir, ketoconazole, and itraconazole, erythromycin, itraconazole, and grapefruit juice,

- Patients taking alcohol,

- Patients with bleeding disorders

- Significant active peptic ulceration,

- Current pregnancy,

- Current breast-feeding.

Locations and Contacts

Department of Clinical Immunology, Army R&R hospital, New Delhi, ND, India

Medicine Unit II, PGIMER, Chandigarh, Punjab, India

Department of Immunology, SGPGIMS, Lucknow, UP 226014, India

Immunology Rheumatology Unit, IPGMER, Kolkatta, WB, India

Additional Information

Starting date: November 2009
Last updated: May 7, 2010

Page last updated: August 23, 2015

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