Skip to content

Trial · Interventional

CompletedPhase 4Results postedRegistry data

Acthar Gel in Participants With Pulmonary Sarcoidosis

Short name PULSAR

Overview

Status
Completed
Phase
Phase 4
Enrollment
55 participants (actual)
Sponsor
Mallinckrodt · Industry
Design
Randomized · Double masking
Countries
1 country

United States

Start
21 Feb 2018
Primary completion
15 Nov 2021
Completion
15 Nov 2021
First posted
25 Oct 2017
Last update posted
27 Feb 2023
Conditions
Sarcoidosis, Pulmonary

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
20182019202020212022
  1. Ph 4

    PULSAR

    NCT03320070

    21 Feb 2018 to 15 Nov 2021

Registry summary

Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.

The purpose of this study is to find out if Acthar Gel is safe and effective to treat pulmonary sarcoidosis. Participants will be randomly assigned (like flipping a coin) to receive a shot under their skin of Acthar Gel or a matching placebo gel that has no drug in it. They will receive their assigned shot twice a week for 24 weeks. All participants who complete the 24-week treatment period will be eligible to receive Acthar Gel for 24 more weeks, even if they were originally in the placebo group.

Interventions

  • Acthar GelDrug
  • PlaceboDrug

Arms2

  • Experimental

    Acthar Gel in DBT Then Acthar Gel in OLE

    Participants received Acthar Gel as a 1 milliliter (mL) injection under the skin, twice weekly, for 24 weeks in the double-blind treatment (DBT) phase. Participants, who chose to continue into the optional OLE phase, then received Acthar Gel as a 1 mL injection under the skin, twice weekly, for another 24 weeks in the optional open-label extension (OLE) phase.

  • Experimental

    Placebo in DBT Then Acthar Gel in OLE

    Participants received Acthar Gel matching placebo as a 1 mL injection under the skin, twice weekly, for 24 weeks in the DBT phase. Participants, who chose to continue into the optional OLE phase, then received Acthar Gel as a 1 mL injection under the skin, twice weekly, for another 24 weeks in the optional OLE phase.

Primary outcomes12

Outcomes the sponsor listed as primary.

  1. DBT: Number of Participants in Each Category of Assessment Based on Forced Vital Capacity (FVC), a Pulmonary Function Test Parameter at Week 24

    Time frame · Week 24

    Registry description

    Forced vital capacity (FVC) is a pulmonary function test parameter that indicates the amount of air that can be forcibly exhaled from the lungs after taking the deepest breath possible. It's measured by spirometry, which is a common breathing test to check lung function. Based on the absolute change of percent predicted, FVC was evaluated to determine if the condition is: * Improved (+1) \[≥ 5% absolute change\] * Unchanged (0) \[\>- 5% to \< 5% absolute change\], or * Worse (-1) \[≤ -5% absolute change\] An additional category "Missing Assessment" indicates the participants who had a missing assessment for this outcome measure.

  2. OLE: Number of Participants in Each Category of Assessment Based on FVC, a Pulmonary Function Test Parameter at Week 48

    Time frame · Week 48

    Registry description

    Forced vital capacity (FVC) is a pulmonary function test parameter that indicates the amount of air that can be forcibly exhaled from the lungs after taking the deepest breath possible. It's measured by spirometry, which is a common breathing test to check lung function. Based on the absolute change of percent predicted, FVC was evaluated to determine if the condition is: * Improved (+1) \[≥ 5% absolute change\] * Unchanged (0) \[\>- 5% to \< 5% absolute change\], or * Worse (-1) \[≤ -5% absolute change\] An additional category "Missing Assessment" indicates the participants who had a missing assessment for this outcome measure.

  3. DBT: Number of Participants in Each Category of Assessment Based on the Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO), a Pulmonary Function Test Parameter at Week 24

    Time frame · Week 24

    Registry description

    The diffusing capacity of the lungs for carbon monoxide (DLCO) measures the ability of the lungs to transfer gas from inhaled air to the red blood cells in the blood. Participants are asked to fully inhale a low concentration of carbon monoxide and an inert tracer gas. Based on the absolute change of percent predicted, DLCO was evaluated to determine if the condition is: * Improved (+1) \[≥ 5% absolute change\] * Unchanged (0) \[\>- 5% to \< 5% absolute change\], * Worse (-1) \[≤ -5% absolute change\] An additional category "Missing Assessment" indicates the participants who had a missing assessment for this outcome measure.

  4. OLE: Number of Participants in Each Category of Assessment Based on the DLCO, a Pulmonary Function Test Parameter at Week 48

    Time frame · Week 48

    Registry description

    The diffusing capacity of the lungs for carbon monoxide (DLCO) measures the ability of the lungs to transfer gas from inhaled air to the red blood cells in the blood. Participants are asked to fully inhale a low concentration of carbon monoxide and an inert tracer gas. Based on the absolute change of percent predicted, DLCO was evaluated to determine if the condition is: * Improved (+1) \[≥ 5% absolute change\] * Unchanged (0) \[\>- 5% to \< 5% absolute change\], * Worse (-1) \[≤ -5% absolute change\] An additional category "Missing Assessment" indicates the participants who had a missing assessment for this outcome measure.

  5. DBT: Number of Participants in Each Category of Assessment Based on High Resolution Computer Tomography (HRCT) at Week 24

    Time frame · Week 24

    Registry description

    High-resolution computer tomography (HRCT) is a type of computed tomography (CT) with specific techniques to enhance image resolution. It is used in the diagnosis of various health problems, most commonly for lung disease. These images show cross sections (slices) through the lungs. HRCT imaging was evaluated by the investigator/radiologist and the central reader to determine if the condition is improved (+1), unchanged (0), or worse (-1). An additional category "Missing Assessment" indicates the participants who had a missing assessment for this outcome measure.

  6. OLE: Number of Participants in Each Category of Assessment Based on HRCT at Week 48

    Time frame · Week 48

    Registry description

    High-resolution computer tomography (HRCT) is a type of computed tomography (CT) with specific techniques to enhance image resolution. It is used in the diagnosis of various health problems, most commonly for lung disease. These images show cross sections (slices) through the lungs. HRCT imaging was evaluated by the investigator/radiologist and the central reader to determine if the condition is improved (+1), unchanged (0), or worse (-1). An additional category "Missing Assessment" indicates the participants who had a missing assessment for this outcome measure.

  7. DBT: Number of Participants in Each Category of Assessment Based on the King's Sarcoidosis Questionnaire (KSQ) (General Health), a Quality of Life Parameter at Week 24

    Time frame · Week 24

    Registry description

    King's sarcoidosis questionnaire (KSQ) (General Health) is a 28-item questionnaire for participants to indicate the status of their sarcoidosis and treatment. Each item was answered on a 7-point scale where 1 means the participant experiences the symptom all the time and 7 means the participant does not experience the symptom at all. Higher scores indicate improvement, and a change of 4 points is considered clinically meaningful. The score on the scale was evaluated to determine if the condition is: * Improved (+1) based on a change of ≥ 4 points * Unchanged (0) based on a change of \>- 4 to \< 4 points * Worse (-1) based on a change of ≤ -4 points An additional category "Missing Assessment" indicates the participants who had a missing assessment for this outcome measure.

  8. OLE: Number of Participants in Each Category of Assessment Based on the KSQ (General Health), a Quality of Life Parameter at Week 48

    Time frame · Week 48

    Registry description

    King's sarcoidosis questionnaire (KSQ) (General Health) is a 28-item questionnaire for participants to indicate the status of their sarcoidosis and treatment. Each item was answered on a 7-point scale where 1 means the participant experiences the symptom all the time and 7 means the participant does not experience the symptom at all. Higher scores indicate improvement, and a change of 4 points is considered clinically meaningful. The score on the scale was evaluated to determine if the condition is: * Improved (+1) based on a change of ≥ 4 points * Unchanged (0) based on a change of \>- 4 to \< 4 points * Worse (-1) based on a change of ≤ -4 points An additional category "Missing Assessment" indicates the participants who had a missing assessment for this outcome measure.

  9. DBT: Number of Participants in Each Category of Assessment Based on the Fatigue Assessment Score (FAS), a Quality of Life Parameter at Week 24

    Time frame · Week 24

    Registry description

    The fatigue assessment score (FAS) is a 10-item checklist for participants to indicate the level of their fatigue. Each item was answered on a 5-point scale where 1 means the participant does not experience the symptom all and 5 means the participant experiences the symptom all the time. Lower scores indicate improvement (less fatigue) and a change of 4 points is considered clinically meaningful. The score on the scale was evaluated to determine if the condition is: * Improved (+1) based on a change of ≤ -4 points * Unchanged (0) based on a change of \>- 4 to \< 4 points * Worse (-1) based on a change of ≥ 4 points An additional category "Missing Assessment" indicates the participants who had a missing assessment for this outcome measure.

  10. OLE: Number of Participants in Each Category of Assessment Based on FAS, a Quality of Life Parameter at Week 48

    Time frame · Week 48

    Registry description

    The fatigue assessment score (FAS) is a 10-item checklist for participants to indicate the level of their fatigue. Each item was answered on a 5-point scale where 1 means the participant does not experience the symptom all and 5 means the participant experiences the symptom all the time. Lower scores indicate improvement (less fatigue) and a change of 4 points is considered clinically meaningful. The score on the scale was evaluated to determine if the condition is: * Improved (+1) based on a change of ≤ -4 points * Unchanged (0) based on a change of \>- 4 to \< 4 points * Worse (-1) based on a change of ≥ 4 points An additional category "Missing Assessment" indicates the participants who had a missing assessment for this outcome measure.

  11. DBT: Number of Participants in Each Category of Assessment Based on Corticosteroid Taper Score in Participants Receiving Each Dose of Prednisone at Week 24

    Time frame · Week 24

    Registry description

    Corticosteroids are first line treatment for sarcoidosis. Concerns of corticosteroid toxicity led to efforts to taper dose sooner. Participants were clinically evaluated at each visit by investigator and categorized by their condition; dose was tapered using algorithm to take them off prednisone using incremental doses of 40,30,20,10,7.5,5,2.5,0 mg, as explained with each category below. * Improved: When condition improved, reduce dose by 1 level * Unchanged: 1. When stable condition without toxicity: At first stable visit they continue same dose; at second stable visit, reduce dose by 1 level 2. When stable condition with toxicity: toxicity is treated; reduce dose by 1 level * Deteriorate: When worsening condition, increase dose by 1 or 2 levels but not \>40mg/day Dose tapering was done based on the participant's clinical condition. Category "Missing Assessment" indicates participants who had a missing assessment for this outcome measure.

  12. OLE: Number of Participants in Each Category of Assessment Based on Corticosteroid Taper Score in Participants Receiving Each Dose of Prednisone at Week 48

    Time frame · Week 48

    Registry description

    Corticosteroids are first line treatment for sarcoidosis. Concerns of corticosteroid toxicity led to efforts to taper dose sooner. Participants were clinically evaluated at each visit by investigator and categorized by their condition; dose was tapered using algorithm to take them off prednisone using incremental doses of 40,30,20,10,7.5,5,2.5,0 mg, as explained with each category below. * Improved: When condition improved, reduce dose by 1 level * Unchanged: 1. When stable condition without toxicity: At first stable visit they continue same dose; at second stable visit, reduce dose by 1 level 2. When stable condition with toxicity: toxicity is treated; reduce dose by 1 level * Deteriorate: When worsening condition, increase dose by 1 or 2 levels but not \>40mg/day Dose tapering was done based on the participant's clinical condition. Category "Missing Assessment" indicates participants who had a missing assessment for this outcome measure.

Posted results

Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.

Primary outcome results

Primary outcomeCount of participants· Week 24

DBT: Number of Participants in Each Category of Assessment Based on Forced Vital Capacity (FVC), a Pulmonary Function Test Parameter at Week 24

GroupValue (Participants)
Acthar Gel in DBT Then Acthar Gel in OLE10
Placebo in DBT Then Acthar Gel in OLE7
Primary outcomeCount of participants· Week 48

OLE: Number of Participants in Each Category of Assessment Based on FVC, a Pulmonary Function Test Parameter at Week 48

GroupValue (Participants)
Acthar Gel in DBT Then Acthar Gel in OLE2
Placebo in DBT Then Acthar Gel in OLE6
Primary outcomeCount of participants· Week 24

DBT: Number of Participants in Each Category of Assessment Based on the Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO), a Pulmonary Function Test Parameter at Week 24

GroupValue (Participants)
Acthar Gel in DBT Then Acthar Gel in OLE5
Placebo in DBT Then Acthar Gel in OLE4
Primary outcomeCount of participants· Week 48

OLE: Number of Participants in Each Category of Assessment Based on the DLCO, a Pulmonary Function Test Parameter at Week 48

GroupValue (Participants)
Acthar Gel in DBT Then Acthar Gel in OLE9
Placebo in DBT Then Acthar Gel in OLE6
Primary outcomeCount of participants· Week 24

DBT: Number of Participants in Each Category of Assessment Based on High Resolution Computer Tomography (HRCT) at Week 24

GroupValue (Participants)
Acthar Gel in DBT Then Acthar Gel in OLE2
Placebo in DBT Then Acthar Gel in OLE1
Primary outcomeCount of participants· Week 48

OLE: Number of Participants in Each Category of Assessment Based on HRCT at Week 48

GroupValue (Participants)
Acthar Gel in DBT Then Acthar Gel in OLE1
Placebo in DBT Then Acthar Gel in OLE6
Primary outcomeCount of participants· Week 24

DBT: Number of Participants in Each Category of Assessment Based on the King's Sarcoidosis Questionnaire (KSQ) (General Health), a Quality of Life Parameter at Week 24

GroupValue (Participants)
Acthar Gel in DBT Then Acthar Gel in OLE11
Placebo in DBT Then Acthar Gel in OLE7
Primary outcomeCount of participants· Week 48

OLE: Number of Participants in Each Category of Assessment Based on the KSQ (General Health), a Quality of Life Parameter at Week 48

GroupValue (Participants)
Acthar Gel in DBT Then Acthar Gel in OLE8
Placebo in DBT Then Acthar Gel in OLE8

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
DBT: Acthar Gel 80 U (1 mL)Participants received Acthar Gel as a 1 mL injection under the skin, twice weekly, for 24 weeks in the DBT phase.0 / 274 / 2722 / 27
DBT: PlaceboParticipants received Acthar Gel matching placebo as a 1 mL injection under the skin, twice weekly, for 24 weeks in the DBT phase.0 / 283 / 2825 / 28
OLE: Acthar Gel 80 U (1 mL) [Received Acthar in DBT]Participants who received Acthar Gel in the DBT phase and opted to continue treatment in OLE phase, received Acthar Gel as a 1 mL injection under the skin, twice weekly, for 24 weeks in the OLE phase.0 / 226 / 2214 / 22
OLE: Acthar Gel 80 U (1 mL) [Received Placebo in DBT]Participants who received Acthar Gel matching placebo in the DBT phase and opted to continue treatment in OLE phase, received Acthar Gel as a 1 mL injection under the skin, twice weekly, for 24 weeks in the OLE phase.0 / 250 / 2514 / 25

Each cell reads participants affected / participants at risk, as the registry posted them.

Registry data comes from ClinicalTrials.gov. Study results come from studies, not from the registry. How PepBank works

Studies1

Studies that cite this trial.

Studies with results

1 study on this page

PubMed tag: none · 2023

6 results

Results From a Phase 4, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study of Repository Corticotropin Injection for the Treatment of Pulmonary Sarcoidosis.

Mirsaeidi et al. 2023Pulmonary therapycited by 15

PMID 37072607PMC10113127DOI 10.1007/s41030-023-00222-2PUB-37072607

Free to read · publisher termsCC BY-NC6 results

Eligibility

Who could join, as posted.

Sex
All
Age
from 18 Years up to 90 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Inclusion Criteria: * Has biopsy-confirmed sarcoidosis meeting American Thoracic Society criteria ≥ 1 year at screening (Visit 1) * Has protocol-defined symptomatic pulmonary disease * Has been receiving a stable prednisone dose between 5 mg and 40 mg (or equivalent) for pulmonary sarcoidosis, for at least 4 weeks before screening, or a stable dose of another disease-modifying anti-sarcoidosis drug for at least 3 months before screening * Has lung function within protocol-defined parameters Exclusion Criteria: * Has at least a 10% change in forced vital capacity (FVC) on spirometry between Visits 1 and 2 * Has pulmonary arterial hypertension requiring treatment * Has been treated with antitumor necrosis factor-α antibody within the past 3 months * Has any pulmonary condition that requires treatment, therefore impeding corticosteroid tapering

PepBank is a research reference. Talk to a doctor before you use any peptide.