A Phase 2 interventional study of Pirfenidone (PFD) and Placebo (Plac) in Scleroderma, Systemic and Interstitial Lung Disease, sponsored by Michael Roth. Completed at 16 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-12-15.
Sponsored by Michael Roth · Phase 2, Interventional, and Treatment
A Phase II multi-center, double-blind, parallel group, randomized and placebo-controlled clinical trial addressing the treatment of patients with active and symptomatic Scleroderma-related interstitial lung disease (SSc-ILD).
A Phase II multi-center, double-blind, parallel group, randomized and placebo-controlled clinical trial addressing the treatment of patients with active and symptomatic Scleroderma-related interstitial lung disease (SSc-ILD). Patients who are either treatment naive or only recently started treatment (\</= 6 months of prior treatment) will be randomized in a 1:1 assignment to receive either oral mycophenolate mofetil (MMF) and a placebo (Plac) or a combination of oral MMF and oral pirfenidone (PFD), with both regimens administered for 18 months. The primary hypothesis is that the rapid onset and anti-fibrotic effects of PFD, which have been observed in the treatment of Idiopathic Pulmonary Fibrosis (IPF), will complement the delayed antiinflammatory and immunosuppressive effects of MMF, to produce a significantly more rapid and/or greater improvement in lung function over time than occurs in patients receiving control therapy with MMF and Plac.
610 studies on the registry are indexed under Scleroderma, Systemic; 218 are open to participants now.
This study's enrollment of 51 is above the median of 37 across 446 interventional studies indexed under Scleroderma, Systemic.
Browse Scleroderma, Systemic studies →Michael Roth is the lead sponsor of 2 studies on the registry; none are open to participants now.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Diffusing capacity of the lung for carbon monoxide adjusted for , expressed as a percentage of the normal predicted value (DLCOHb-%) of \<30% at screening or \<25% at baseline.
a) All participants with a DLCOHb-% between 30 to 40% must have pulmonary artery pressures documented by either echocardiogram, right heart catheterization or magnetic resonance imaging in order to be considered for inclusion.
Hematologic abnormality at screening including:
Participants with an identified and correctable etiology may be eligible if repeat testing within the maximal 90-day screening period meets all criteria.
History of recurrent aspiration, uncontrolled heartburn, or gastroesophageal reflux disease (GERD) with a reflux scale score of >1.00 as determined by a UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Scale (UCLA SCTC GIT), Version 2.0.
Participants with uncontrolled heartburn or GERD that is amenable to medical management may be eligible if repeat testing within the maximal 90-day screening period meets this criteria.
Prior use of potential disease modifying antirheumatic drugs (DMARDs) according to the following exposure rules:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.
The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).
Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.
Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.
Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).
Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.
Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
FEV1
From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Hemoglobin (Hb)
The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Clinically significant
Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Platelets
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Bilirubin
A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.
Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Postmenopausal
Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraception
Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.
Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Immunosuppression
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Cancer (malignancy)
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants will receive Placebo (Plac) as add-on to a background therapy of Mycophenolate Mofetil (MMF).
Drug: Placebo (Plac) · Drug: Mycophenolate Mofetil (MMF)
Participants will receive Pirfenidone (PFD) as add-on to a background therapy of Mycophenolate Mofetil (MMF).
Drug: Pirfenidone (PFD) · Drug: Mycophenolate Mofetil (MMF)
Participants will receive PFD titrated up to a target dose of 801 mg taken three times daily as tolerated (3-step titration occurring at 2 week intervals).
Also known as: Esbriet
Participants will receive a Plac, matched to resemble PFD, titrated up to a target dose of 801 mg taken three times daily as tolerated (3-step titration occurring at 2 week intervals).
Also known as: Inactive capsule
Participants will receive MMF titrated up to a target dose of 1500 mg taken twice daily as tolerated (4-step titration occurring at monthly intervals).
Also known as: generic for Cellcept
Percent Predicted Forced Vital Capacity (FVC-%)
Change from baseline to month 18 in the mean forced vital capacity (represented as the percentage of the age-; height-; gender-; and race-adjusted predicted value, i.e. FVC-%).
Time frame: Baseline to 18 months
Percent Predicted Single-breath Diffusing Capacity for Carbon Monoxide (DLCOHb-%)
Change from baseline to month 18 in DLCO, calculated as a percent of the age-; height-; gender-; race-; and hemoglobin-adjusted predicted value (DLCOHb-%). The raw DLCO value and adjusting it for all of these factors and presenting it as a percent of predicted (expected) is the outcome measure (DLCOHb-%).
Time frame: Baseline to 18 months
Modified Rodnan Skin Score (mRSS)
Change from baseline to month 18 in the mRSS. mRSS scores have a range from 0 to 51, with higher score indicating greater skin involvement.
Time frame: Baseline to 18 months
Forced Vital Capacity Volume (FVC, in ml)
Change from baseline to month 18 in the Forced Vital Capacity volume (FVC, in ml)
Time frame: Baseline to 18 months
Mahler Modified Transitional Dyspnea Index (TDI)
The change from baseline to 18 months in dyspnea. The TDI score for each of three domains ranges from -3 (major deterioration) to +3 (major improvement). The sum of all domains yields the TDI total score (-9 to +9).
Time frame: Baseline to 18 months
Health Assessment Questionnaire Modified for Scleroderma (HAQ-DI)
Change from baseline to month 18 as a subjective measure of dyspnea and quality of life. HAQ-DI ranges from 0 (no disability) to 3 (severe disability).
Time frame: Baseline to 18 months
St. George's Respiratory Questionnaire (SGRQ)
Change from baseline to month 18 as a subjective measure of dyspnea and quality of life. SGRQ ranges from 0 (no impairment) to 100 (maximum impairment).
Time frame: Baseline to 18 months
High Resolution Computerized Tomography (HRCT) Measures of Quantitative Lung Fibrosis Score in the Whole Lung (QLF-WL)
Change from screening to month 18 in computer-generated scoring of HRCT data from the whole lung for the percentage of imaging pixels that exhibit features characteristic for lung fibrosis. Individual image scores range 0 to 100%, with higher percentages representing greater extent of quantitative lung fibrosis.
Time frame: Screening to 18 months
High Resolution Computerized Tomography (HRCT) Measures of Quantitative Lung Fibrosis Score in the Lobe of Maximal Involvement (QLF-LM)
Change from screening to month 18 in computer-generated scoring of HRCT data for the percentage of imaging pixels that exhibit features characteristic for lung fibrosis within the lobe of maximal involvement at baseline. Individual image score range 0 to 100%, with higher percentages representing greater extent of quantitative lung fibrosis.
Time frame: Screening to 18 months
High Resolution Computerized Tomography (HRCT) Measures of Quantitative Interstitial Lung Disease Score in the Whole Lung (QILD-WL)
Change from screening to month 18 in computer-generated scoring of HRCT data from the whole lung for the percentage of imaging pixels that exhibit features of any of the three patterns of interstitial lung disease (ILD) including quantitative ground-glass opacity (QGG), lung fibrosis (QLF) and quantitative honeycombing (QHC). Individual image scores range 0 to 100%, with higher percentages representing greater extent of quantitative interstitial lung disease.
Time frame: Screening to 18 months
High Resolution Computerized Tomography (HRCT) Measures of Quantitative Interstitial Lung Disease Score in the Lobe of Maximal Involvement (QILD-LM)
Change from screening to month 18 in computer-generated scoring of HRCT data for the percentage of imaging pixels exhibiting features characteristic for any of three patterns of ILD (including QGG, QLF and QHC) within the lobe of maximal involvement at baseline. Individual image scores range 0 to 100%, with higher percentages representing greater extent of quantitative interstitial lung disease.
Time frame: Screening to 18 months
High Resolution Computerized Tomography (HRCT) Measures of Total Lung Capacity (TLC)
Change from screening to 18 months in quantitative HRCT measurement of TLC at maximal inspiration (HRCT-TLC). Higher scores indicates a better outcome.
Time frame: Screening to 18 months
3.0% or Greater Improvement From Baseline in FVC-%.
The time (in months) required for each treatment arm to achieve a 3.0% or greater improvement from baseline in the FVC-% over the 18-month treatment period.
Time frame: Baseline to 18 months
Greater Than 5% Improvement in FVC-%
The percentage of subjects in each treatment arm achieving greater than a 5% improvement in FVC-% over the 18-month treatment period.
Time frame: Baseline to 18 months
Percentage of Participants Achieving Specified Absolute Changes of FVC-%
The percentage of participants in each treatment arm achieving either improvements in the absolute change of FVC-% from baseline to 18 months by up to 5%, from 5% to \<10% and from 10% to \<15% or worsening by up to 5%, from 5% to \<10% and from 10% to \<15%. The descriptive analysis is presented.
Time frame: Baseline to 18 months
Percentage of Participants Achieving Specified Absolute Changes of FVC-% Defined as Positive or Negative Responders
The percentage of participants in each treatment arm who are defined as positive responders (improved at least 3% or more) or negative responders (worsened at least 3% or more), and stable (\>-3% to \<3%). The descriptive analysis is presented.
Time frame: Baseline to 18 months
Percentage of Participants Achieving Specified Absolute Changes of FVC-% Defined as Any Responders or Any Non-responders
The percentage of participants in each treatment arm who are defined as any responders (improved \>0%) or any non-responders (worsened \</=0%). The descriptive analysis is presented.
Time frame: Baseline to 18 months
Percentage of Participants Achieving Specified Absolute Changes of mRSS
The percentage of participants in each treatment arm achieving changes in 4 point increments: worsen (1 to 4, \>/=5), no change (=0), improved (\</=-13, -12 to -9, -8 to -5, -4 to -1). The descriptive analysis is presented.
Time frame: Baseline to 18 months
Percentage of Participants Achieving Specified Absolute Changes of mRSS Defined as Improved, no Change and Decreased.
The percentage of participants in each treatment arm achieving changes defined as improved (\</=-5), no change (-5 to 5), and decreased (\>5). The descriptive analysis is presented.
Time frame: Baseline to 18 months
Percentage of Participants Achieving Specified TDI Focal Score at 18 Months
The percentage of participants in each treatment arm achieving either improvements in the TDI focal score at 18 months by 1-3, 4-6 and 7-9 points, no change (0) and worsened by 1-3, 4-6and 7-9 points. The descriptive analysis is presented.
Time frame: 18 months
Percentage of Participants Achieving Specified TDI Focal Score at 18 Months Defined as Improved, no Change or Deterioration
The percentage of participants in each treatment arm achieving TDI focal scores defined as improved (\>0), no change and deterioration (\<0). The descriptive analysis is presented.
Time frame: 18 months
Time to Withdrawal From the Study Drug or Treatment Failure
The time from start of treatment to withdrawal or removal from active drug therapy (MMF or Plac/PFD separately) for any reason will be plotted over the course of the 18-month treatment as a measure of tolerability and toxicity. Median times to withdrawal are not available for reporting as less than half of the participants discontinued the study drugs.
Time frame: Baseline to 18 months
Number of Participants With Treatment-related Adverse Events as Assessed by System Organ Classification Using Preferred Medical Dictionary for Regulatory Activities (MedDRA) Terms.
Adverse Events (AE) and Serious Adverse Events (SAE), classified according to preferred MedDRA terms, were systematically recorded over the course of the 18-month treatment period as a measure of toxicity. Total number of participants experiencing adverse events reported here. Complete breakdown of AE and SAE by MedDRA terms is reported in the Adverse Events section.
Time frame: Baseline to 18 months
| Milestone | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Started | 24 | 27 |
| Completed | 23 | 25 |
| Not completed | 1 | 2 |
| Withdrew: Lost to follow-up | 0 | 1 |
| Withdrew: Withdrawal by subject | 1 | 1 |
Change from baseline to month 18 in the mean forced vital capacity (represented as the percentage of the age-; height-; gender-; and race-adjusted predicted value, i.e. FVC-%).
| percent predicted | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Percent Predicted Forced Vital Capacity (FVC-%) | 2.24 ± 1.351 | 2.09 ± 1.278 |
Change from baseline to month 18 in DLCO, calculated as a percent of the age-; height-; gender-; race-; and hemoglobin-adjusted predicted value (DLCOHb-%). The raw DLCO value and adjusting it for all of these factors and presenting it as a percent of predicted (expected) is the outcome measure (DLCOHb-%).
| percent predicted | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Percent Predicted Single-breath Diffusing Capacity for Carbon Monoxide (DLCOHb-%) | 1.25 ± 1.549 | 1.24 ± 1.505 |
Change from baseline to month 18 in the mRSS. mRSS scores have a range from 0 to 51, with higher score indicating greater skin involvement.
| score on a scale | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Modified Rodnan Skin Score (mRSS) | -5.42 ± 1.164 | -4.96 ± 1.109 |
Change from baseline to month 18 in the Forced Vital Capacity volume (FVC, in ml)
| ml | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Forced Vital Capacity Volume (FVC, in ml) | 121.53 ± 62.41 | 112.33 ± 59.055 |
The change from baseline to 18 months in dyspnea. The TDI score for each of three domains ranges from -3 (major deterioration) to +3 (major improvement). The sum of all domains yields the TDI total score (-9 to +9).
| score on a scale | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Mahler Modified Transitional Dyspnea Index (TDI) | 1.13 ± 0.754 | 1.99 ± 0.710 |
Change from baseline to month 18 as a subjective measure of dyspnea and quality of life. HAQ-DI ranges from 0 (no disability) to 3 (severe disability).
| score on a scale | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Health Assessment Questionnaire Modified for Scleroderma (HAQ-DI) | -0.03 ± 0.109 | -0.17 ± 0.103 |
Change from baseline to month 18 as a subjective measure of dyspnea and quality of life. SGRQ ranges from 0 (no impairment) to 100 (maximum impairment).
| score on a scale | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| St. George's Respiratory Questionnaire (SGRQ) | -4.77 ± 3.487 | -6.11 ± 3.212 |
Change from screening to month 18 in computer-generated scoring of HRCT data from the whole lung for the percentage of imaging pixels that exhibit features characteristic for lung fibrosis. Individual image scores range 0 to 100%, with higher percentages representing greater extent of quantitative lung fibrosis.
| percent | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| High Resolution Computerized Tomography (HRCT) Measures of Quantitative Lung Fibrosis Score in the Whole Lung (QLF-WL) | 1.46 ± 0.994 | -0.11 ± 0.935 |
Change from screening to month 18 in computer-generated scoring of HRCT data for the percentage of imaging pixels that exhibit features characteristic for lung fibrosis within the lobe of maximal involvement at baseline. Individual image score range 0 to 100%, with higher percentages representing greater extent of quantitative lung fibrosis.
| percent | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| High Resolution Computerized Tomography (HRCT) Measures of Quantitative Lung Fibrosis Score in the Lobe of Maximal Involvement (QLF-LM) | 2.57 ± 2.276 | 0.13 ± 2.132 |
Change from screening to month 18 in computer-generated scoring of HRCT data from the whole lung for the percentage of imaging pixels that exhibit features of any of the three patterns of interstitial lung disease (ILD) including quantitative ground-glass opacity (QGG), lung fibrosis (QLF) and quantitative honeycombing (QHC). Individual image scores range 0 to 100%, with higher percentages representing greater extent of quantitative interstitial lung disease.
| percent | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| High Resolution Computerized Tomography (HRCT) Measures of Quantitative Interstitial Lung Disease Score in the Whole Lung (QILD-WL) | 2.36 ± 1.919 | -1.15 ± 1.829 |
Change from screening to month 18 in computer-generated scoring of HRCT data for the percentage of imaging pixels exhibiting features characteristic for any of three patterns of ILD (including QGG, QLF and QHC) within the lobe of maximal involvement at baseline. Individual image scores range 0 to 100%, with higher percentages representing greater extent of quantitative interstitial lung disease.
| percent | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| High Resolution Computerized Tomography (HRCT) Measures of Quantitative Interstitial Lung Disease Score in the Lobe of Maximal Involvement (QILD-LM) | 2.99 ± 2.634 | -0.99 ± 2.486 |
Change from screening to 18 months in quantitative HRCT measurement of TLC at maximal inspiration (HRCT-TLC). Higher scores indicates a better outcome.
| ml | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| High Resolution Computerized Tomography (HRCT) Measures of Total Lung Capacity (TLC) | 70.69 ± 78.986 | 191.99 ± 73.738 |
The time (in months) required for each treatment arm to achieve a 3.0% or greater improvement from baseline in the FVC-% over the 18-month treatment period.
| months | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| 3.0% or Greater Improvement From Baseline in FVC-%. | 17.8 (8.9 to NA) | 12.3 (3.6 to 18.3) |
The percentage of subjects in each treatment arm achieving greater than a 5% improvement in FVC-% over the 18-month treatment period.
| Participants | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Greater Than 5% Improvement in FVC-% | 6 | 9 |
The percentage of participants in each treatment arm achieving either improvements in the absolute change of FVC-% from baseline to 18 months by up to 5%, from 5% to \<10% and from 10% to \<15% or worsening by up to 5%, from 5% to \<10% and from 10% to \<15%. The descriptive analysis is presented.
| Participants | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| ≥ 10% to < 15% | 1 | 1 |
| ≥ 5% to < 10% | 5 | 8 |
| > 0% to < 5% | 10 | 6 |
| > -5% to ≤ 0% | 5 | 6 |
| > -10% to ≤ -5% | 1 | 2 |
The percentage of participants in each treatment arm who are defined as positive responders (improved at least 3% or more) or negative responders (worsened at least 3% or more), and stable (\>-3% to \<3%). The descriptive analysis is presented.
| Participants | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Positive responder (≥ 3%) | 8 | 11 |
| Stable (> -3 to < 3) | 10 | 8 |
| Negative responder (≤ -3%) | 4 | 4 |
The percentage of participants in each treatment arm who are defined as any responders (improved \>0%) or any non-responders (worsened \</=0%). The descriptive analysis is presented.
| Participants | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Responder (> 0%) | 16 | 15 |
| Non-responder (≤ 0%) | 6 | 8 |
The percentage of participants in each treatment arm achieving changes in 4 point increments: worsen (1 to 4, \>/=5), no change (=0), improved (\</=-13, -12 to -9, -8 to -5, -4 to -1). The descriptive analysis is presented.
| Participants | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| ≤ -13 | 2 | 6 |
| -12 to -9 | 1 | 0 |
| -8 to -5 | 4 | 4 |
| -4 to -1 | 8 | 9 |
| 0 | 3 | 3 |
| 1 to 4 | 1 | 1 |
| ≥ 5 | 1 | 0 |
The percentage of participants in each treatment arm achieving changes defined as improved (\</=-5), no change (-5 to 5), and decreased (\>5). The descriptive analysis is presented.
| Participants | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Worsening (change > 5) | 0 | 0 |
| No Change (-5 ≤ change ≤ 5) | 15 | 13 |
| Improvement (change < -5) | 5 | 10 |
The percentage of participants in each treatment arm achieving either improvements in the TDI focal score at 18 months by 1-3, 4-6 and 7-9 points, no change (0) and worsened by 1-3, 4-6and 7-9 points. The descriptive analysis is presented.
| Participants | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| 7 to 9 | 0 | 0 |
| 4 to 6 | 1 | 1 |
| 1 to 3 | 4 | 5 |
| 0 | 8 | 8 |
| -3 to -1 | 6 | 2 |
| -6 to -4 | 3 | 5 |
| -9 to -7 | 1 | 4 |
The percentage of participants in each treatment arm achieving TDI focal scores defined as improved (\>0), no change and deterioration (\<0). The descriptive analysis is presented.
| Participants | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Worsening (change < 0) | 5 | 6 |
| No Change (change = 0) | 8 | 8 |
| Improvement (change > 0) | 10 | 11 |
The time from start of treatment to withdrawal or removal from active drug therapy (MMF or Plac/PFD separately) for any reason will be plotted over the course of the 18-month treatment as a measure of tolerability and toxicity. Median times to withdrawal are not available for reporting as less than half of the participants discontinued the study drugs.
| days | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Time to Withdrawal From the Study Drug or Treatment Failure | NA (NA to NA) | NA (NA to NA) |
Adverse Events (AE) and Serious Adverse Events (SAE), classified according to preferred MedDRA terms, were systematically recorded over the course of the 18-month treatment period as a measure of toxicity. Total number of participants experiencing adverse events reported here. Complete breakdown of AE and SAE by MedDRA terms is reported in the Adverse Events section.
| Participants | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| Number of Participants With Treatment-related Adverse Events as Assessed by System Organ Classification Using Preferred Medical Dictionary for Regulatory Activities (MedDRA) Terms. | 23 | 27 |
Collected over 1 year and 6 months. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Placebo (Plac) + Mycophenolate (MMF) | 0/24 (0%) | 2/24 (8.3%) | 23/24 (95.8%) |
| Pirfenidone (PFD) + Mycophenolate (MMF) | 0/27 (0%) | 4/27 (14.8%) | 27/27 (100%) |
| Event | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| ColitisGastrointestinal disorders | 1/24 | 0/27 |
| Covid-19 InfectionInfections and infestations | 1/24 | 0/27 |
| Acute Chronic Hypoxemic Respiratory FailureRespiratory, thoracic and mediastinal disorders | 1/24 | 0/27 |
| Right Sided Chest PainCardiac disorders | 0/24 | 1/27 |
| Herpes Zoster OphthalmicusInfections and infestations | 0/24 | 1/27 |
| Basal Cell Carcinoma, NodularNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/24 | 1/27 |
| Extra-nodal Marginal Zone B-cell Lymphoma of the Stomach and AntrumNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/24 | 1/27 |
| Scleroderma Renal CrisisRenal and urinary disorders | 0/24 | 1/27 |
| DyspneaRespiratory, thoracic and mediastinal disorders | 0/24 | 1/27 |
| Event | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) |
|---|---|---|
| NauseaGastrointestinal disorders | 7/24 | 22/27 |
| DiarrheaGastrointestinal disorders | 10/24 | 12/27 |
| Vomiting (Emesis)Gastrointestinal disorders | 4/24 | 11/27 |
| FatigueGeneral disorders | 5/24 | 8/27 |
| CoughRespiratory, thoracic and mediastinal disorders | 5/24 | 7/27 |
| HeadacheGeneral disorders | 5/24 | 6/27 |
| Abdominal PainGastrointestinal disorders | 5/24 | 4/27 |
| BronchitisRespiratory, thoracic and mediastinal disorders | 5/24 | 0/27 |
| DizzinessGeneral disorders | 1/24 | 5/27 |
| Dry EyesEye disorders | 4/24 | 0/27 |
Safety population includes all the randomized participants who received at least one dose of study medication.
| Age, Continuous(years) | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) | Total |
|---|---|---|---|
| Mean | 52.6 ± 10 | 56.6 ± 9.9 | 54.7 ± 10.1 |
| Sex: Female, Male(Participants) | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) | Total |
|---|---|---|---|
| Female | 17 | 19 | 36 |
| Male | 7 | 8 | 15 |
| Race (NIH/OMB)(Participants) | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 1 | 1 | 2 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 2 | 3 | 5 |
| White | 19 | 22 | 41 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 2 | 1 | 3 |
| Region of Enrollment(participants) | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) | Total |
|---|---|---|---|
| United States | 24 | 27 | 51 |
| Scleroderma Classification(Participants) | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) | Total |
|---|---|---|---|
| Sine | 3 | 3 | 6 |
| Limited | 13 | 11 | 24 |
| Diffuse | 8 | 13 | 21 |
| Disease Duration(months) | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) | Total |
|---|---|---|---|
| Mean | 32.9 ± 24.2 | 28.9 ± 25.4 | 30.8 ± 24.7 |
| Percent predicted forced vital capacity (FVC-%)(percent predicted) | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) | Total |
|---|---|---|---|
| Mean | 71.5 ± 9.9 | 70.6 ± 11.0 | 71.0 ± 10.4 |
| Forced Vital Capacity volume (FVC)(ml) | Placebo (Plac) + Mycophenolate (MMF) | Pirfenidone (PFD) + Mycophenolate (MMF) | Total |
|---|---|---|---|
| Mean | 2705 ± 540 | 2610 ± 781 | 2655 ± 674 |
9 further baseline measures are reported on the registry.
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: Yes — A bio-specimen repository will be created in which de-identified blood specimens will be made available to qualified researchers who submit meritorious applications for the access and use of such samples. Requests for specimens and correlative analyses related to other linked and de-identified clinical data will be overseen by the Study Executive and Steering Committees and/or any sub-committees that they may appoint for this process.
Time frame: Sharing will be made available after completion of the clinical trial and reporting of the primary outcome.
Access criteria: Access criteria will be made available after 01/01/2018 through the study website noted below.
Data sharing details ↗ · sclerodermalungstudy.org
Ran from Nov 2017 to primary completion in Mar 2022, 51 months.
Results were first posted in Dec 2023, 1 year 8 months after primary completion.
Of 48 phase 2 interventional studies under Scleroderma, Systemic, half reached primary completion within 37 months of starting (the median), counting those still running; a quarter within 24 and three quarters within 83. This study's 51 months is above that.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Dec 2023. You cannot join it, but the record below documents what was studied.
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Studies of the drug tested here: Pirfenidone
Michael Roth