1/2 kids MOD PAH trial: mono- VS. DUO-therapy in pediatric pulmonary arterial hypertension

Active Cooperative Agreement Awarded Last action

Award ID
UH3HL151458
Recipient
Awarding agency
Obligated
$14,200,870

Award facts

Assistance listing
93.837 Cardiovascular Diseases Research
Completion date 98% complete
Place of performance
Baltimore, MD 21205, USA

Award details come from USAspending.gov.

Description

Abstract
Pulmonary arterial hypertension (PAH) contributes to high morbidity and mortality in children with diverse cardiopulmonary and systemic diseases. Efforts to define optimal treatment strategies for pediatric PAH have been limited by the absence of multicenter randomized controlled trials (mrcts) and the lack of well-defined and proven endpoints for studies in children. Pediatric PAH remains understudied and relatively little is known about long-term outcomes, age-appropriate clinical endpoints and optimal therapeutic strategies for children. Drug treatment remains suboptimal as mrcts are rare in children with PAH and current decision-making is dependent on data from adult studies or small case series in children. Based on recent success of mrcts in establishing a new standard of care for adult PAH patients, we propose to study the potential role for initial up-front combination treatment of PAH in children consisting of two PAH-specific oral therapies that have been shown to be well- tolerated in children as monotherapies: sildenafil (a type v phosphodiesterase inhibitor) and bosentan (an endothelin receptor antagonist). Recent studies in adult PAH suggest that initiation of combined therapy with a phosphodiesterase 5 inhibitor and an endothelin receptor antagonist at the time of diagnosis, rather than sequential combination therapy, improves pulmonary hemodynamics, exercise tolerance and quality of life when compared with monotherapy. Children with PAH often require additional therapies over time in the setting of disease progression or incomplete responsiveness to monotherapy, however, there are no data regarding the potential benefits of greater and more sustained clinical improvement over time with the more aggressive combination therapy approach from the time of initial diagnosis. Studies of pediatric PAH have been further limited by the lack of well-coordinated and experienced care programs and the relative rare nature of these diseases. With the collaboration of the pediatric pulmonary hypertension network (pphnet), a highly interactive and multidisciplinary group of academic PH programs, we propose to test the hypothesis that initiation of up-front combination therapy with sildenafil and bosentan at the time of PAH diagnosis will result in improved who functional class (FC) at 12 months in comparison with the current standard approach, which is sildenafil therapy alone. Overall, this study addresses critical gaps in pediatric PAH by testing a clinical strategy with strong potential for broad impact, and by defining useful study endpoints or novel surrogates that will facilitate evidence-based decision-making and enhance the care of children with PAH.

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Original award $1,298,939
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Subawards

Subrecipient Amount Awarded
The Medical College Of Wisconsin, Inc. 1/2 Kids MoD PAH Trial: Mono- vs. Duo-Therapy In Pediatric Pulmonary Arterial hypertension $51,267
The Regents Of The University Of Colorado $145,605
New York Medical College 1/2 Kids MoD PAH Trial: Mono- vs. Duo-Therapy In Pediatric Pulmonary Arterial Hypertension $135,794
Seattle Children's Hospital 1/2 Kids MoD PAH Trial: Mono- vs. Duo-Therapy In Pediatric Pulmonary Arterial hypertension $73,036
The Trustees Of Columbia University In The City Of New York $295,459
The Children's Hospital Corporation $89,966
Duke University 1/2 Kids MoD PAH Trial: Mono- vs. Duo-Therapy In Pediatric Pulmonary Arterial Hypertension $76,201
Baylor College Of Medicine 1/2 Kids MoD PAH Trial: Mono- vs. Duo-Therapy In Pediatric Pulmonary Arterial hypertension $68,918
All Childrens Research Institute Inc. $62,753
Childrens Hospital Medical Center $32,100
The Children's Hospital Of Philadelphia $62,348
University Of Utah $30,800
Vanderbilt University Medical Center $36,486
The Regents Of The University Of California. San Francisco $54,450
The Governors Of The University Of Alberta $34,709
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Quick answers

Who received award UH3HL151458?

UH3HL151458 was awarded to The Johns Hopkins University by National Heart Lung and Blood Institute (National Institutes of Health) on September 15, 2021.

How much is award UH3HL151458 worth?

$14,200,870 has been obligated on UH3HL151458.

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