RecruitingPhase 3NCT07179380

Efficacy and Safety Study of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Hypertension Associated With Interstitial Lung Disease (PH-ILD)

A Phase 3, Randomized, Double-blind, Placebo-controlled, Multicenter, Parallel Group Study to Evaluate the Efficacy and Safety of Treprostinil Palmitil Inhalation Powder in Participants With Pulmonary Hypertension Associated With Interstitial Lung Disease


Sponsor

Insmed Incorporated

Enrollment

344 participants

Start Date

Jan 7, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

The primary objective of this study is to evaluate the effect of 24-weeks of once daily treatment with TPIP versus placebo on exercise capacity in adults with PH-ILD.


Eligibility

Min Age: 18 Years

Inclusion Criteria9

  • Diagnosis of PH World Health Organisation (WHO) Group 3 associated with ILD \[including but not limited to idiopathic interstitial pneumonia (IIP), chronic hypersensitivity pneumonitis (HSP), connective tissue disease-associated interstitial lung disease (CTD-ILD), combined pulmonary fibrosis and emphysema (CPFE)\].
  • Confirmation of fibrotic interstitial lung disease by centrally overread computed tomography (CT) scan performed at Screening or within prior 12 months.
  • PH confirmed by right heart catheterization (RHC) at Screening or within 12 months prior to Screening, with the following hemodynamic findings:
  • Mean pulmonary arterial pressure (mPAP) \>20 millimetre of mercury (mmHg) and
  • Pulmonary capillary wedge pressure (PCWP) of ≤15 mmHg and
  • Pulmonary vascular resistance (PVR) ≥4 wood units (WU).
  • Minute walking distance (6MWD) ≥100 and ≤500 meters at two 6MWTs at Screening performed at least 4 hours apart, with the difference between the 2 distances ≤15%.
  • Participants receiving chronic medication for underlying disease (e.g., antifibrotic, immunomodulators, immunosuppressants, etc.) and/or phosphodiesterase 5 (PDE5) inhibitors, should be on this treatment for ≥90 days and on a stable dose for ≥30 days prior to Screening.
  • Capable of giving signed informed consent as described in Section 10.1.5 which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

Exclusion Criteria13

  • Diagnosis of Pulmonary Hypertension WHO Groups 1, 2, 4, or 5, or subtypes of PH WHO Group 3 other than interstitial lung disease.
  • Primary diagnosis of chronic obstructive pulmonary disease (COPD) and/or forced expiratory volume in 1 second (FEV1)/FVC \<0.7 (based on screening or historical spirometry within the prior 6 months).
  • Clinically significant left heart disease:
  • evidence of clinically significant left-sided valvular heart disease,
  • left ventricular failure with left ventricular ejection fraction (LVEF) \<45%, or diagnosis of heart failure with preserved ejection fraction (HFpEF)
  • echocardiography findings at Screening suggestive for postcapillary PH
  • unstable ischemic heart disease
  • unstable arrhythmia, including uncontrolled atrial fibrillation (rate-controlled arrhythmia or paroxysmal atrial fibrillation is allowed)
  • Evidence of chronic thromboembolic disease or recent (within 6 months of Screening) acute pulmonary embolism.
  • Known hypersensitivity or contraindication to treprostinil or TPIP or TPIP formulation excipients (e.g., mannitol, leucine).
  • Current use of cigarettes or e-cigarettes: An adult who has smoked at least 100 cigarettes in his or her lifetime and who currently smokes either every day or some days.
  • Current use of inhaled marijuana, recreational or medical (current use defined as used at least one or more times during the past 30 days prior to Screening) or expected use during the study.
  • Any other medical or psychological condition including relevant laboratory abnormalities at Screening that, in the opinion of the Investigator, suggest a new and/or insufficiently understood disease and/or may present an unreasonable risk to the study participant as a result of his/her participation in this clinical trial, may impede their ability complete the study or the study assessments or confound the outcomes of the trial.

Interventions

DRUGTreprostinil Palmitil Inhalation Powder

Oral inhalation using a capsule-based dry powder inhaler device.

DRUGPlacebo

Oral inhalation using a capsule-based dry powder inhaler device.


Locations(30)

USA001

Santa Barbara, California, United States

USA006

Naples, Florida, United States

USA003

Bend, Oregon, United States

USA008

Richmond, Virginia, United States

GEO002

Tbilisi, Georgia

GEO004

Tbilisi, Georgia

GEO003

Tbilisi, Georgia

GEO001

Tbilisi, Georgia

DEU003

München, Bavaria, Germany

DEU005

Immenhausen, Hesse, Germany

DEU010

Gauting, Germany

ISR003

Petah Tikva, Central District, Israel

ISR001

Haifa, Israel

ISR002

Jerusalem, Israel

ISR004

Tel Aviv, Israel

JPN002

Narashino-shi, Chiba, Japan

JPN004

Narita, Chiba, Japan

JPN001

Sapporo, Hokkaido, Japan

JPN007

Yokohama, Kanagawa, Japan

JPN013

Bunkyo-Ku, Tokyo, Japan

JPN008

Kiyose, Tokyo, Japan

JPN003

Shibuya City, Tokyo, Japan

JPN005

Nagano, Japan

NZL001

Christchurch, Canterbury, New Zealand

NZL002

Dunedin, Otago, New Zealand

ESP004

Barcelona, Spain

ESP006

Madrid, Spain

ESP009

Madrid, Spain

ESP011

Santiago de Compostela, Spain

ESP001

Seville, Spain

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NCT07179380


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