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selexipag

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Description

selexipag: prostacyclin receptor agonist [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

selexipag : A member of the class of pyrazines that is N-(methanesulfonyl)-2-{4-[(propan-2-yl)(pyrazin-2-yl)amino]butoxy}acetamide carrying two additional phenyl substituents at positions 5 and 6 on the pyrazine ring. An orphan drug used for the treatment of pulmonary arterial hypertension. It is a prodrug for ACT-333679 (the free carboxylic acid). [Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Cross-References

ID SourceID
PubMed CID9913767
CHEMBL ID238804
CHEBI ID90844
SCHEMBL ID674122
MeSH IDM0514408

Synonyms (63)

Synonym
ns-304
act-293987
CHEMBL238804
selexipag
2-{4-[n-(5,6-diphenylpyrazin-2-yl)-n-isopropylamino]butyloxy}-n-(methylsulfonyl)acetamide
selexipag (jan/usan/inn)
475086-01-2
uptravi (tn)
D09994
ns 304
act 293987
2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)-n-(methylsulfonyl)acetamide
selexipag [usan:inn]
unii-5exc0e384l
2-(4-((5,6-diphenylpyrazin-2-yl)(propan-2-yl)amino)butoxy}-n-(methanesulfonyl)acetamide
5exc0e384l ,
uptravi
act293987
S3726
selexipag [orange book]
selexipag [inn]
selexipag [jan]
selexipag [who-dd]
2-{4-[(5,6-diphenylpyrazin-2-yl)(propan-2-yl)amino]butoxy}-n-(methanesulfonyl)acetamide
selexipag [mi]
selexipag [usan]
gtpl7552
2-[4-[[5,6-di(phenyl)pyrazin-2-yl]-propan-2-ylamino]butoxy]-n-methylsulfonylacetamide
SCHEMBL674122
CS-3774
CHEBI:90844 ,
QXWZQTURMXZVHJ-UHFFFAOYSA-N
2-[4-[(5,6-diphenyl-2-pyrazinyl)(1-methylethyl)amino]butoxy]-n-(methylsulfonyl)acetamide
HY-14870
AC-30209
AKOS024457572
DB11362
2-{4-[(5,6-diphenylpyrazin-2-yl)(propan-2-yl)amino]butoxy}-n-methanesulfonylacetamide
NCGC00370833-01
ns-304(selexipag)
mfcd10567093
BS-16872
2-(4-((5,6-diphenyl-2-pyrazinyl)(isopropyl)amino)butoxy)-n-(methylsulfonyl)acetamide
BCP09146
bdbm50235383
Q15424759
AMY10851
selexipag(ns-304)
SB17055
2-[4-[(5,6-diphenylpyrazin-2-yl)-propan-2-ylamino]butoxy]-n-methylsulfonylacetamide
CCG-269668
ns-304;act-293987
FT-0776043
NCGC00370833-02
A857156
EN300-7378417
DTXSID301027959
2-[4-[(5,6-diphenyl-2-pyrazinyl)(1-methylethyl)amino]butoxy]-n-(methylsulfonyl)acetamide; 2-[4-[(5,6-diphenylpyrazin-2-yl)(isopropyl)amino]butoxy]-n-(methylsulfonyl)acetamide; act 293987; ns 304; uptravi;
uptravi titration pack
selexipagum
2-(4-((5,6-diphenylpyrazin-2-yl)(propan-2-yl)amino)butoxy)-n-(methanesulfonyl)acetamide
b01ac27
EX-A7991

Research Excerpts

Overview

Slexipag is a first-in-class, oral, long-acting, selective, non-prostanoid agonist of the prostacyclin receptor (IP receptor), indicated for the treatment of symptomatic adult pulmonary arterial hypertension (PAH)

ExcerptReferenceRelevance
"Selexipag is a new drug with mild adverse reactions and is safe for the treatment of PAH. "( Efficacy and safety of selexipag, an oral prostacyclin receptor agonist for the treatment of pulmonary hypertension: A meta-analysis.
Chen, M; Chen, R; Hong, C; Lai, Y; Liu, H; Lu, J; Wang, D; Zhang, Y; Zheng, Z; Zhong, Y, 2022
)
2.47
"Selexipag is an oral selective IP prostacyclin receptor agonist approved for the treatment of SSc-related pulmonary arterial hypertension."( Preliminary Clinical and Laser Speckle Contrast Analysis Data on Selexipag Efficacy for the Treatment of Digital Vasculopathy in Systemic Sclerosis.
Da Rio, M; De Mattia, G; Della Rossa, A; Di Battista, M; Morganti, R; Mosca, M, 2023
)
1.87
"Selexipag is an orally available prostacyclin receptor agonist."( Transitioning intravenous epoprostenol to oral selexipag in idiopathic pulmonary arterial hypertension: a case report.
Alexandre, A; Alves, J; Carvalho, L; Furtado, I; Gonçalves, F; Melo, A; Reis, A; Santos, M, 2023
)
1.89
"Selexipag is a prostacyclin receptor agonist approved for the treatment of pulmonary arterial hypertension. "( Clopidogrel, a CYP2C8 inhibitor, causes a clinically relevant increase in the systemic exposure to the active metabolite of selexipag in healthy subjects.
Axelsen, LN; Bruderer, S; Perez Ruixo, JJ; Poggesi, I; Rasschaert, F, 2021
)
2.27
"Selexipag is an oral nonprostanoid IP prostacyclin receptor agonist that is indicated for treatment of pulmonary arterial hypertension (PAH). "( Rapid transition from oral selexipag to parenteral treprostinil in a patient with mixed-etiology pulmonary hypertension.
DeChristopher, A; Fann, J; Feldman, J; Irandost, M; Radosevich, JJ, 2020
)
2.3
"Selexipag is a first-in-class, oral, long-acting, selective, non-prostanoid agonist of the prostacyclin receptor (IP receptor), indicated for the treatment of symptomatic adult pulmonary arterial hypertension (PAH). "( An evaluation of selexipag for the treatment of pulmonary hypertension.
Boutou, A; Panagiotidou, E; Pitsiou, G, 2021
)
2.4
"Selexipag is a recently approved, orally available and selective prostacyclin receptor agonist with a non-prostanoid structure."( The selective PGI2 receptor agonist selexipag ameliorates Sugen 5416/hypoxia-induced pulmonary arterial hypertension in rats.
Fuchikami, C; Honda, Y; Kosugi, K; Kuramoto, K; Kuwano, K; Numakura, Y, 2020
)
1.55
"Selexipag is a selective oral prostacyclin receptor agonist indicated for pulmonary arterial hypertension (PAH) treatment. "( Patient and disease characteristics of the first 500 patients with pulmonary arterial hypertension treated with selexipag in real-world settings from SPHERE.
Chakinala, MM; Chin, KM; Farber, HW; Hemnes, AR; Highland, KB; Kim, NH; McLaughlin, V; Narayan, V; Zhao, C, 2021
)
2.28
"Selexipag is an orally available prostacyclin receptor (IP receptor) agonist with a non-prostanoid structure. "( Efficacy and Safety of an Orally Administered Selective Prostacyclin Receptor Agonist, Selexipag, in Japanese Patients With Pulmonary Arterial Hypertension.
Anzai, T; Fukuda, K; Hashimoto, A; Hatano, M; Ikeda, S; Inoue, T; Ito, H; Kajinami, K; Kihara, Y; Kinoshita, H; Kuwahara, K; Murohara, T; Nakayama, T; Okazaki, O; Sakai, S; Sasayama, S; Satoh, T; Tahara, N; Takeda, Y; Takeishi, Y; Tanabe, N; Taniguchi, M; Watanabe, H; Yamamoto, T; Yamauchi-Takihara, K; Yoshioka, K, 2017
)
2.12
"Selexipag is an efficacious treatment option for Japanese PAH patients."( Efficacy and Safety of an Orally Administered Selective Prostacyclin Receptor Agonist, Selexipag, in Japanese Patients With Pulmonary Arterial Hypertension.
Anzai, T; Fukuda, K; Hashimoto, A; Hatano, M; Ikeda, S; Inoue, T; Ito, H; Kajinami, K; Kihara, Y; Kinoshita, H; Kuwahara, K; Murohara, T; Nakayama, T; Okazaki, O; Sakai, S; Sasayama, S; Satoh, T; Tahara, N; Takeda, Y; Takeishi, Y; Tanabe, N; Taniguchi, M; Watanabe, H; Yamamoto, T; Yamauchi-Takihara, K; Yoshioka, K, 2017
)
1.4
"Selexipag is an oral prostacyclin IP receptor agonist approved for use as monotherapy or in combination with other therapies to slow PAH progression and reduce the risk of hospitalization in patients with FC II or III symptoms. "( Selexipag for the treatment of pulmonary arterial hypertension.
Kido, K; Macaulay, TE; Noel, ZR, 2017
)
3.34
"Selexipag (Uptravi) is an oral selective IP prostacyclin receptor agonist approved for the treatment of pulmonary arterial hypertension (PAH). "( Population Modeling of Selexipag Pharmacokinetics and Clinical Response Parameters in Patients With Pulmonary Arterial Hypertension.
Bruderer, S; Dingemanse, J; Hurst, N; Krause, A; Lott, D; Machacek, M, 2017
)
2.21
"Selexipag is an oral, non-prostanoid, selective prostacyclin receptor agonist recently marketed for the treatment of pulmonary arterial hypertension (PAH) in adults. "( Biocomparison Study of Adult and Paediatric Dose Strengths of the Prostacyclin Receptor Agonist Selexipag.
Boehler, M; Bruderer, S; Dingemanse, J; Ulč, I, 2018
)
2.14
"Selexipag is an inhibitor of CYP2C8 and CYP2C9 and induces CYP3A4 and CYP2C9 in vitro."( The metabolism and drug-drug interaction potential of the selective prostacyclin receptor agonist selexipag.
Äänismaa, P; de Kanter, R; Delahaye, S; Gnerre, C; Ichikawa, T; Pfeifer, T; Seeland, S; Segrestaa, J; Treiber, A; Yamada, T, 2018
)
1.42
"Selexipag is a valuable addition to PAH therapeutics especially by reducing the PAH-related hospitalizations and thus improving quality of life in PAH patients."( A Special Focus on Selexipag - Treatment of Pulmonary Arterial Hypertension.
Grimm, D; Infanger, M; Kruger, M; Nassef, MZ; Simonsen, U; Sorensen, LM; Wehland, M, 2017
)
2.23
"Selexipag is a prostacyclin receptor agonist synthesized for the treatment of pulmonary arterial hypertension."( Effects of selexipag and its active metabolite in contrasting the profibrotic myofibroblast activity in cultured scleroderma skin fibroblasts.
Brizzolara, R; Corallo, C; Cutolo, M; Giordano, N; Montagna, P; Paolino, S; Parodi, A; Pizzorni, C; Ruaro, B; Scabini, S; Smith, V; Soldano, S; Stratta, E; Sulli, A; Tavilla, PP; Trombetta, AC, 2018
)
1.59
"Selexipag is an enteral, selective prostacyclin IP receptor agonist approved for pulmonary hypertension in adults. "( Transition from intravenous treprostinil to enteral selexipag in an infant with pulmonary arterial hypertension.
Bock, MJ; Koo, R; Lo, J, 2019
)
2.21
"Selexipag is a first-in-class orally available selective non-prostanoid IP receptor agonist. "( Selexipag for the treatment of pulmonary arterial hypertension.
Lang, IM; Skoro-Sajer, N, 2014
)
3.29
"Selexipag is an orally available and selective prostacyclin receptor (IP receptor) agonist."( Pharmacokinetics and Tolerability of the Novel Oral Prostacyclin IP Receptor Agonist Selexipag.
Bruderer, S; Dingemanse, J; Kaufmann, P; Mant, T; Mukai, H; Okubo, K; Yamada, T, 2015
)
1.36
"Selexipag is a novel, oral, selective prostacyclin (PGI2) receptor agonist in clinical development for the treatment of pulmonary arterial hypertension. "( Bioequivalence of different dose-strength tablets of selexipag, a selective prostacyclin receptor agonist, in a multiple-dose up-titration study.
Baldoni, D; Bruderer, S; Dingemanse, J; Muhsen, N, 2015
)
2.11
"Selexipag is a novel oral, selective agonist of the PGI2 (IP) receptor."( Selexipag for the treatment of pulmonary arterial hypertension.
Sharma, K, 2016
)
2.6
"Selexipag (Uptravi(®)) is a highly selective, long-acting, nonprostanoid, prostacyclin receptor agonist that is being developed by Actelion Pharmaceuticals Ltd and Nippon Shinyaku. "( Selexipag: First Global Approval.
Scott, LJ, 2016
)
3.32
"Selexipag is a new orally available nonprostanoid prostacyclin receptor agonist for the treatment of pulmonary arterial hypertension. "( Investigation of Potential Pharmacodynamic and Pharmacokinetic Interactions Between Selexipag and Warfarin in Healthy Male Subjects.
Bruderer, S; Dingemanse, J; Mant, T; Mukai, H; Okubo, K, 2016
)
2.1
"Selexipag is a recently developed, non-prostanoid, oral IP receptor agonist for the treatment of PAH which has been approved in countries/regions including the USA and Europe."( Selexipag for the treatment of pulmonary arterial hypertension.
Gall, H; Ghofrani, HA; Grimminger, F; Grimminger, J; Richter, MJ, 2016
)
2.6
"Selexipag is an oral prostacyclin (PGI"( Selexipag in Pulmonary Arterial Hypertension: Most Updated Evidence From Recent Preclinical and Clinical Studies.
Ball, S; Bandyopadhyay, D; Das, A; Ghosh, RK; Gupta, A; Mondal, S; Saha, D, 2017
)
2.62

Effects

ExcerptReferenceRelevance
"Selexipag has a high selectivity for the IP2-receptor and differs from conventional prostacyclin analogues in its chemical structure."( A Special Focus on Selexipag - Treatment of Pulmonary Arterial Hypertension.
Grimm, D; Infanger, M; Kruger, M; Nassef, MZ; Simonsen, U; Sorensen, LM; Wehland, M, 2017
)
1.5
"Selexipag has been approved and is used in the clinical treatment of PAH worldwide."( The selective PGI2 receptor agonist selexipag ameliorates Sugen 5416/hypoxia-induced pulmonary arterial hypertension in rats.
Fuchikami, C; Honda, Y; Kosugi, K; Kuramoto, K; Kuwano, K; Numakura, Y, 2020
)
1.55

Treatment

Oral selexipag was considered as a treatment which adds value, compared to iloprost, in the following MCDA quantitative criteria: comparative efficacy, patient reported outcomes, preventive benefit, therapeutic benefit, other medical costs and other non-medical costs. There were no significant differences in safety profile but with a higher acquisition cost than inhaled Iloprost.

ExcerptReferenceRelevance
"Oral selexipag for PAH treatment was considered as a treatment which adds value, compared to iloprost, in the following MCDA quantitative criteria: comparative efficacy, patient reported outcomes, preventive benefit, therapeutic benefit, other medical costs and other non-medical costs, without significant differences in safety profile but with a higher acquisition cost than inhaled iloprost."( Determining the value contribution of selexipag for the treatment of pulmonary arterial hypertension (PAH) in Spain using reflective multi-criteria decision analysis (MCDA).
Ais, A; Beaudet, A; Gil, A; Jiménez, A, 2018
)
1.27
"Treatment with selexipag did not reduce the number of RP attacks compared with placebo. "( Efficacy and Safety of Selexipag in Adults With Raynaud's Phenomenon Secondary to Systemic Sclerosis: A Randomized, Placebo-Controlled, Phase II Study.
Denton, CP; Frenoux, JM; Frey, A; Hachulla, É; Herrick, AL; Le Brun, FO; Riemekasten, G; Schwarting, A, 2017
)
1.12

Toxicity

Selexipag is a new drug with mild adverse reactions and is safe for the treatment of PAH. The adverse reactions were mild with headache, diarrhea and nausea reported as the main symptoms.

ExcerptReferenceRelevance
" The adverse events in the selexipag group were consistent with the known side effects of prostacyclin, including headache, nausea, jaw pain, and diarrhea."( Clinical pharmacology, efficacy, and safety of selexipag for the treatment of pulmonary arterial hypertension.
Bruderer, S; Dingemanse, J; Hurst, N; Remenova, T, 2017
)
1.01
" Other outcome measures included Raynaud's Condition Score (RCS), RP attack duration, and treatment-emergent adverse events (AEs)."( Efficacy and Safety of Selexipag in Adults With Raynaud's Phenomenon Secondary to Systemic Sclerosis: A Randomized, Placebo-Controlled, Phase II Study.
Denton, CP; Frenoux, JM; Frey, A; Hachulla, É; Herrick, AL; Le Brun, FO; Riemekasten, G; Schwarting, A, 2017
)
0.77
" During the study, 3 patients discontinued selexipag due to adverse events."( Safety and tolerability of transition from inhaled treprostinil to oral selexipag in pulmonary arterial hypertension: Results from the TRANSIT-1 study.
Benza, RL; Chin, KM; Eggert, M; Farber, HW; Fisher, M; Fortin, TA; Fritz, JS; Frost, A; Janmohamed, M; Kim, NH; McConnell, JW; McEvoy, C; McLaughlin, V; Miller, CE; Pfister, T; Poch, D; Shiraga, Y, 2019
)
1.01
"Oral selexipag use in children with PAH is well tolerated and safe when closely monitored."( Selexipag for the treatment of children with pulmonary arterial hypertension: First multicenter experience in drug safety and efficacy.
Bukova, M; Chouvarine, P; Hansmann, G; Koestenberger, M; Meinel, K; Wåhlander, H, 2020
)
2.51
" Fifteen patients had adverse events (AEs), most were mild, and none resulted in discontinuation."( Temporarily switching from oral to intravenous selexipag in patients with pulmonary arterial hypertension: safety, tolerability, and pharmacokinetic results from an open-label, phase III study.
Axelsen, LN; Chin, KM; Ewert, R; Gall, H; Hsu Schmitz, SF; Klose, H; Parambil, J; Poch, D; Preston, IR; Seyfarth, HJ; Stein, C, 2021
)
0.88
" Patients were followed for adverse events (AE) and survival from selexipag initiation up to 3 days and 30 days after end of treatment, respectively."( Long-Term Survival, Safety and Tolerability with Selexipag in Patients with Pulmonary Arterial Hypertension: Results from GRIPHON and its Open-Label Extension.
Channick, R; Chin, KM; Coghlan, JG; Gaine, S; Galiè, N; Hoeper, MM; Hsu Schmitz, SF; Lang, IM; Lassen, C; McLaughlin, VV; Rubin, LJ; Sitbon, O; Tapson, VF, 2022
)
1.21
" The adverse reactions of selexipag were mild with headache, diarrhea and nausea reported as the main symptoms."( Efficacy and safety of selexipag, an oral prostacyclin receptor agonist for the treatment of pulmonary hypertension: A meta-analysis.
Chen, M; Chen, R; Hong, C; Lai, Y; Liu, H; Lu, J; Wang, D; Zhang, Y; Zheng, Z; Zhong, Y, 2022
)
1.33
"Selexipag is a new drug with mild adverse reactions and is safe for the treatment of PAH."( Efficacy and safety of selexipag, an oral prostacyclin receptor agonist for the treatment of pulmonary hypertension: A meta-analysis.
Chen, M; Chen, R; Hong, C; Lai, Y; Liu, H; Lu, J; Wang, D; Zhang, Y; Zheng, Z; Zhong, Y, 2022
)
2.47
" The most common side effect profiles were headache, nausea, abdominal pain, jaw pain, myalgia, and diarrhoea."( Clinical efficacy and safety of selexipag in children and young adults with idiopathic and heritable pulmonary arterial hypertension.
Kawai, R; Matsuura, H; Nakayama, T; Shimizu, Y; Takatsuki, S, 2023
)
1.19
"Optimizing an individual dose with careful management of adverse events (AEs) is essential in the treatment with selexipag approved for pulmonary arterial hypertension (PAH)."( Real-world practice patterns and characteristics of adverse events with selexipag in Korean patients with pulmonary arterial hypertension.
Chang, HJ; Chang, SA; Choi, JH; Choi, JY; Chung, WJ; Jung, HO; Jung, SY; Kim, HK; Kim, WJ; Lee, SH; Park, SM, 2022
)
1.16

Pharmacokinetics

Steady-state levels of selexipag and ACT-333679 after repeated doses of 400 μg selexIPag had no influence on the warfarin pharmacodynamic variables. The 90% CIs of the geometric mean ratios of AUC and Cmax for R- and S-warfarin were inside the reference range.

ExcerptReferenceRelevance
" Possible pharmacodynamic and pharmacokinetic interactions between selexipag and warfarin in healthy individuals were investigated."( Investigation of Potential Pharmacodynamic and Pharmacokinetic Interactions Between Selexipag and Warfarin in Healthy Male Subjects.
Bruderer, S; Dingemanse, J; Mant, T; Mukai, H; Okubo, K, 2016
)
0.89
"Steady-state levels of selexipag and ACT-333679 after repeated doses of 400 μg selexipag had no influence on the warfarin pharmacodynamic variables."( Investigation of Potential Pharmacodynamic and Pharmacokinetic Interactions Between Selexipag and Warfarin in Healthy Male Subjects.
Bruderer, S; Dingemanse, J; Mant, T; Mukai, H; Okubo, K, 2016
)
0.97
" A 24-h pharmacokinetic profile was performed following midazolam administration, and bioequivalence criteria were investigated on an exploratory basis."( A pharmacokinetic drug-drug interaction study between selexipag and midazolam, a CYP3A4 substrate, in healthy male subjects.
Boehler, M; Bruderer, S; Dingemanse, J; Donazzolo, Y; Juif, PE, 2017
)
0.7
" The present study evaluated the possible pharmacokinetic interactions of selexipag with gemfibrozil, a strong CYP2C8 inhibitor, and rifampicin, an inducer of CYP2C8."( Effect of gemfibrozil and rifampicin on the pharmacokinetics of selexipag and its active metabolite in healthy subjects.
Boehler, M; Bruderer, S; Dingemanse, J; Halabi, A; Petersen-Sylla, M; Remeňová, T, 2017
)
0.92
" Safety outcomes were monitored throughout, and pharmacokinetic samples were obtained after oral and IV administration."( Temporarily switching from oral to intravenous selexipag in patients with pulmonary arterial hypertension: safety, tolerability, and pharmacokinetic results from an open-label, phase III study.
Axelsen, LN; Chin, KM; Ewert, R; Gall, H; Hsu Schmitz, SF; Klose, H; Parambil, J; Poch, D; Preston, IR; Seyfarth, HJ; Stein, C, 2021
)
0.88

Compound-Compound Interactions

ExcerptReferenceRelevance
" However, due to its low dose and relatively low unbound exposure, selexipag has a low potential for causing drug-drug interactions."( The metabolism and drug-drug interaction potential of the selective prostacyclin receptor agonist selexipag.
Äänismaa, P; de Kanter, R; Delahaye, S; Gnerre, C; Ichikawa, T; Pfeifer, T; Seeland, S; Segrestaa, J; Treiber, A; Yamada, T, 2018
)
0.93

Bioavailability

The absolute oral bioavailability of selexipag (90% CI) was 49. The bioavailability after oral administration is approximately 50%.

ExcerptReferenceRelevance
"The aim of this single-center, open-label study was to assess the absolute bioavailability of an oral (tablet) versus intravenous (i."( Absolute oral bioavailability of selexipag, a novel oral prostacyclin IP receptor agonist.
Astruc, B; Dingemanse, J; Hurst, N; Kaufmann, P, 2017
)
0.74
" The absolute oral bioavailability of selexipag (90% CI) was 49."( Absolute oral bioavailability of selexipag, a novel oral prostacyclin IP receptor agonist.
Astruc, B; Dingemanse, J; Hurst, N; Kaufmann, P, 2017
)
1.01
" The bioavailability of selexipag after oral administration is approximately 50%."( Absolute oral bioavailability of selexipag, a novel oral prostacyclin IP receptor agonist.
Astruc, B; Dingemanse, J; Hurst, N; Kaufmann, P, 2017
)
1.04
"The ATP-binding cassette transporter P-glycoprotein (P-gp) is known to limit both brain penetration and oral bioavailability of many chemotherapy drugs."( A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
Ambudkar, SV; Brimacombe, KR; Chen, L; Gottesman, MM; Guha, R; Hall, MD; Klumpp-Thomas, C; Lee, OW; Lee, TD; Lusvarghi, S; Robey, RW; Shen, M; Tebase, BG, 2019
)
0.51

Dosage Studied

Slexipag may enable earlier combination therapy targeting the three-molecular pathways of PAH with anticipated improvements in daily- and long-term clinical function and outcome in PAH. The dosing flexibility afforded by oral selexipags may facilitate achieving the maximum therapeutic effect.

ExcerptRelevanceReference
" Dosage was up-titrated in 200-μg increments from 200 μg twice daily on day 1 to the maximum tolerated dose by day 35 (maximum allowed dose of 800 μg twice daily)."( Selexipag: an oral, selective prostacyclin receptor agonist for the treatment of pulmonary arterial hypertension.
Bonderman, D; Degano, B; Delcroix, M; Efficace, M; Galiè, N; Giorgino, R; Hoeper, MM; Karlócai, K; Kurzyna, M; Lang, IM; Simonneau, G; Torbicki, A, 2012
)
1.82
"9 h, thus permitting oral dosing twice daily."( Selexipag for the treatment of pulmonary arterial hypertension.
Lang, IM; Skoro-Sajer, N, 2014
)
1.85
" By combining oral dosing with improved receptor selectivity, selexipag may enable earlier combination therapy targeting the three-molecular pathways of PAH with anticipated improvements in daily- and long-term clinical function and outcome in PAH."( Selexipag for the treatment of pulmonary arterial hypertension.
Sharma, K, 2016
)
2.12
" Pharmacokinetic properties of ACT-333679 permit twice-daily dosing of selexipag, providing a more convenient treatment compared to prostacyclin or its analogs."( Clinical pharmacology, efficacy, and safety of selexipag for the treatment of pulmonary arterial hypertension.
Bruderer, S; Dingemanse, J; Hurst, N; Remenova, T, 2017
)
0.95
" The dosing flexibility afforded by oral selexipag may facilitate achieving the maximum therapeutic effect with acceptable tolerability in patients with PAH."( Selexipag, a selective prostacyclin receptor agonist in pulmonary arterial hypertension: a pharmacology review.
Honorato Pérez, J, 2017
)
2.16
" The impact of the route of delivery and the optimal dosing for transitioning inhaled treprostinil to oral treprostinil or selexipag is unknown."( Different efficacy of inhaled and oral medications in pulmonary hypertension.
AbuHalimeh, BJ; Parambil, JG; Tonelli, AR,
)
0.34
"The pharmacology, pharmacokinetics, clinical efficacy, safety and tolerability, dosing and administration, and place in therapy of selexipag, an orally administered selective prostacyclin receptor agonist for the treatment of pulmonary arterial hypertension (PAH), are reviewed."( Selexipag for the treatment of pulmonary arterial hypertension.
Kido, K; Macaulay, TE; Noel, ZR, 2017
)
2.1
" The recommended initial selexipag dosage is 200 μg twice daily."( Selexipag for the treatment of pulmonary arterial hypertension.
Kido, K; Macaulay, TE; Noel, ZR, 2017
)
2.2
" The use of these medications is challenging due to complexity in dosing and their side effect profiles which limit patient tolerability and acceptance."( What Is the Role of Oral Prostacyclin Pathway Medications in Pulmonary Arterial Hypertension Management?
El Yafawi, R; Wirth, JA, 2017
)
0.46
"3% of patients, the individualized maintenance dosage of selexipag was ≤800 μg twice daily."( Efficacy and Safety of Selexipag in Adults With Raynaud's Phenomenon Secondary to Systemic Sclerosis: A Randomized, Placebo-Controlled, Phase II Study.
Denton, CP; Frenoux, JM; Frey, A; Hachulla, É; Herrick, AL; Le Brun, FO; Riemekasten, G; Schwarting, A, 2017
)
1.01
"There is a paucity of published data on how to safely transition patients to oral therapy in the event of complications and problems during parenteral administration of prostacyclins, which can include bloodstream infections, injection-site pain (with use of subcutaneous treprostinil), infusion pump malfunction, and dosing errors due to incorrect dose preparation."( Transition from treprostinil to selexipag in patients with pulmonary arterial hypertension: Case series.
Fanous, SM; Janmohamed, M, 2018
)
0.76
" PK modelling and simulation were conducted to support dosing recommendations."( Clopidogrel, a CYP2C8 inhibitor, causes a clinically relevant increase in the systemic exposure to the active metabolite of selexipag in healthy subjects.
Axelsen, LN; Bruderer, S; Perez Ruixo, JJ; Poggesi, I; Rasschaert, F, 2021
)
0.83
"Our results demonstrated the impact of clopidogrel on the pharmacokinetics of selexipag and its active metabolite and suggested that selexipag should be carefully prescribed with clopidogrel with dose adjustment or reducing the dosing frequency in Japanese clinical settings."( Clinical evaluation of drug-drug interactions between the cytochrome P450 substrates selexipag and clopidogrel in Japanese volunteers.
Hakamata, A; Inui, N; Kamiya, C; Katayama, N; Namiki, N; Odagiri, K; Tanaka, S; Tatsumi, K; Uchida, S; Watanabe, H, 2021
)
1.07
" Three serious AEs occurred in two patients with underlying comorbidities when oral dosing had resumed."( Temporarily switching from oral to intravenous selexipag in patients with pulmonary arterial hypertension: safety, tolerability, and pharmacokinetic results from an open-label, phase III study.
Axelsen, LN; Chin, KM; Ewert, R; Gall, H; Hsu Schmitz, SF; Klose, H; Parambil, J; Poch, D; Preston, IR; Seyfarth, HJ; Stein, C, 2021
)
0.88
" The dose-titration pattern, AE incidences by dosing and time course, recovery pattern from AEs, and relationship between doses and AE incidences were evaluated."( Real-world practice patterns and characteristics of adverse events with selexipag in Korean patients with pulmonary arterial hypertension.
Chang, HJ; Chang, SA; Choi, JH; Choi, JY; Chung, WJ; Jung, HO; Jung, SY; Kim, HK; Kim, WJ; Lee, SH; Park, SM, 2022
)
0.95
" Selexipag was started at dosage of 200 μg twice daily (b."( Transitioning intravenous epoprostenol to oral selexipag in idiopathic pulmonary arterial hypertension: a case report.
Alexandre, A; Alves, J; Carvalho, L; Furtado, I; Gonçalves, F; Melo, A; Reis, A; Santos, M, 2023
)
2.08
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Roles (5)

RoleDescription
orphan drugAny drug that has been developed specifically for treatment of a rare medical condition, the condition itself being known as an orphan disease.
prostacyclin receptor agonistAn agonist that binds to and activates prostacyclin receptors
platelet aggregation inhibitorA drug or agent which antagonizes or impairs any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.
vasodilator agentA drug used to cause dilation of the blood vessels.
prodrugA compound that, on administration, must undergo chemical conversion by metabolic processes before becoming the pharmacologically active drug for which it is a prodrug.
[role information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Drug Classes (6)

ClassDescription
monocarboxylic acid amideA carboxamide derived from a monocarboxylic acid.
etherAn organooxygen compound with formula ROR, where R is not hydrogen.
pyrazines
aromatic amineAn amino compound in which the amino group is linked directly to an aromatic system.
tertiary amino compoundA compound formally derived from ammonia by replacing three hydrogen atoms by organyl groups.
N-sulfonylcarboxamideA mixed diacylamine resulting from the formal condensation of the nitrogen of a carboxamide with a sulphonic acid.
[compound class information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Protein Targets (11)

Potency Measurements

ProteinTaxonomyMeasurementAverage (µ)Min (ref.)Avg (ref.)Max (ref.)Bioassay(s)
cytochrome P450 family 3 subfamily A polypeptide 4Homo sapiens (human)Potency16.93300.01237.983543.2770AID1645841
GVesicular stomatitis virusPotency23.91850.01238.964839.8107AID1645842
cytochrome P450 2D6Homo sapiens (human)Potency21.31740.00108.379861.1304AID1645840
Interferon betaHomo sapiens (human)Potency23.91850.00339.158239.8107AID1645842
HLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)Potency23.91850.01238.964839.8107AID1645842
Spike glycoproteinSevere acute respiratory syndrome-related coronavirusPotency39.81070.009610.525035.4813AID1479145
Inositol hexakisphosphate kinase 1Homo sapiens (human)Potency23.91850.01238.964839.8107AID1645842
cytochrome P450 2C9, partialHomo sapiens (human)Potency23.91850.01238.964839.8107AID1645842
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Inhibition Measurements

ProteinTaxonomyMeasurementAverageMin (ref.)Avg (ref.)Max (ref.)Bioassay(s)
Prostacyclin receptorHomo sapiens (human)IC50 (µMol)0.06200.00840.07040.2880AID1437828
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Activation Measurements

ProteinTaxonomyMeasurementAverageMin (ref.)Avg (ref.)Max (ref.)Bioassay(s)
Prostacyclin receptorHomo sapiens (human)EC50 (µMol)0.00600.00040.05450.3470AID1437825
Prostacyclin receptorRattus norvegicus (Norway rat)EC50 (µMol)0.20000.00070.10030.2000AID1437823
Prostaglandin D2 receptorHomo sapiens (human)EC50 (µMol)0.10000.00060.49212.0590AID1437826
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Biological Processes (59)

Processvia Protein(s)Taxonomy
cell surface receptor signaling pathway via JAK-STATInterferon betaHomo sapiens (human)
response to exogenous dsRNAInterferon betaHomo sapiens (human)
B cell activation involved in immune responseInterferon betaHomo sapiens (human)
cell surface receptor signaling pathwayInterferon betaHomo sapiens (human)
cell surface receptor signaling pathway via JAK-STATInterferon betaHomo sapiens (human)
response to virusInterferon betaHomo sapiens (human)
positive regulation of autophagyInterferon betaHomo sapiens (human)
cytokine-mediated signaling pathwayInterferon betaHomo sapiens (human)
natural killer cell activationInterferon betaHomo sapiens (human)
positive regulation of peptidyl-serine phosphorylation of STAT proteinInterferon betaHomo sapiens (human)
cellular response to interferon-betaInterferon betaHomo sapiens (human)
B cell proliferationInterferon betaHomo sapiens (human)
negative regulation of viral genome replicationInterferon betaHomo sapiens (human)
innate immune responseInterferon betaHomo sapiens (human)
positive regulation of innate immune responseInterferon betaHomo sapiens (human)
regulation of MHC class I biosynthetic processInterferon betaHomo sapiens (human)
negative regulation of T cell differentiationInterferon betaHomo sapiens (human)
positive regulation of transcription by RNA polymerase IIInterferon betaHomo sapiens (human)
defense response to virusInterferon betaHomo sapiens (human)
type I interferon-mediated signaling pathwayInterferon betaHomo sapiens (human)
neuron cellular homeostasisInterferon betaHomo sapiens (human)
cellular response to exogenous dsRNAInterferon betaHomo sapiens (human)
cellular response to virusInterferon betaHomo sapiens (human)
negative regulation of Lewy body formationInterferon betaHomo sapiens (human)
negative regulation of T-helper 2 cell cytokine productionInterferon betaHomo sapiens (human)
positive regulation of apoptotic signaling pathwayInterferon betaHomo sapiens (human)
response to exogenous dsRNAInterferon betaHomo sapiens (human)
B cell differentiationInterferon betaHomo sapiens (human)
natural killer cell activation involved in immune responseInterferon betaHomo sapiens (human)
adaptive immune responseInterferon betaHomo sapiens (human)
T cell activation involved in immune responseInterferon betaHomo sapiens (human)
humoral immune responseInterferon betaHomo sapiens (human)
positive regulation of T cell mediated cytotoxicityHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
adaptive immune responseHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
antigen processing and presentation of endogenous peptide antigen via MHC class I via ER pathway, TAP-independentHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
regulation of T cell anergyHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
defense responseHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
immune responseHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
detection of bacteriumHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
regulation of interleukin-12 productionHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
regulation of interleukin-6 productionHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
protection from natural killer cell mediated cytotoxicityHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
innate immune responseHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
regulation of dendritic cell differentiationHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
antigen processing and presentation of endogenous peptide antigen via MHC class IbHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
G protein-coupled receptor signaling pathway, coupled to cyclic nucleotide second messengerProstacyclin receptorHomo sapiens (human)
adenylate cyclase-activating G protein-coupled receptor signaling pathwayProstacyclin receptorHomo sapiens (human)
cell-cell signalingProstacyclin receptorHomo sapiens (human)
negative regulation of platelet-derived growth factor receptor signaling pathwayProstacyclin receptorHomo sapiens (human)
response to lipopolysaccharideProstacyclin receptorHomo sapiens (human)
negative regulation of smooth muscle cell proliferationProstacyclin receptorHomo sapiens (human)
positive regulation of cytosolic calcium ion concentrationProstacyclin receptorHomo sapiens (human)
inflammatory responseProstacyclin receptorHomo sapiens (human)
G protein-coupled receptor signaling pathwayProstaglandin D2 receptorHomo sapiens (human)
male sex determinationProstaglandin D2 receptorHomo sapiens (human)
sleepProstaglandin D2 receptorHomo sapiens (human)
mast cell degranulationProstaglandin D2 receptorHomo sapiens (human)
adenosine metabolic processProstaglandin D2 receptorHomo sapiens (human)
cellular response to prostaglandin D stimulusProstaglandin D2 receptorHomo sapiens (human)
positive regulation of cytosolic calcium ion concentrationProstaglandin D2 receptorHomo sapiens (human)
inflammatory responseProstaglandin D2 receptorHomo sapiens (human)
inositol phosphate metabolic processInositol hexakisphosphate kinase 1Homo sapiens (human)
phosphatidylinositol phosphate biosynthetic processInositol hexakisphosphate kinase 1Homo sapiens (human)
negative regulation of cold-induced thermogenesisInositol hexakisphosphate kinase 1Homo sapiens (human)
inositol phosphate biosynthetic processInositol hexakisphosphate kinase 1Homo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Molecular Functions (22)

Processvia Protein(s)Taxonomy
cytokine activityInterferon betaHomo sapiens (human)
cytokine receptor bindingInterferon betaHomo sapiens (human)
type I interferon receptor bindingInterferon betaHomo sapiens (human)
protein bindingInterferon betaHomo sapiens (human)
chloramphenicol O-acetyltransferase activityInterferon betaHomo sapiens (human)
TAP bindingHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
signaling receptor bindingHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
protein bindingHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
peptide antigen bindingHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
TAP bindingHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
protein-folding chaperone bindingHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
guanyl-nucleotide exchange factor activityProstacyclin receptorHomo sapiens (human)
prostacyclin receptor activityProstacyclin receptorHomo sapiens (human)
prostaglandin J receptor activityProstaglandin D2 receptorHomo sapiens (human)
prostaglandin D receptor activityProstaglandin D2 receptorHomo sapiens (human)
protein bindingProstaglandin D2 receptorHomo sapiens (human)
inositol-1,3,4,5,6-pentakisphosphate kinase activityInositol hexakisphosphate kinase 1Homo sapiens (human)
inositol hexakisphosphate kinase activityInositol hexakisphosphate kinase 1Homo sapiens (human)
inositol heptakisphosphate kinase activityInositol hexakisphosphate kinase 1Homo sapiens (human)
inositol hexakisphosphate 5-kinase activityInositol hexakisphosphate kinase 1Homo sapiens (human)
protein bindingInositol hexakisphosphate kinase 1Homo sapiens (human)
ATP bindingInositol hexakisphosphate kinase 1Homo sapiens (human)
inositol hexakisphosphate 1-kinase activityInositol hexakisphosphate kinase 1Homo sapiens (human)
inositol hexakisphosphate 3-kinase activityInositol hexakisphosphate kinase 1Homo sapiens (human)
inositol 5-diphosphate pentakisphosphate 5-kinase activityInositol hexakisphosphate kinase 1Homo sapiens (human)
inositol diphosphate tetrakisphosphate kinase activityInositol hexakisphosphate kinase 1Homo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Ceullar Components (23)

Processvia Protein(s)Taxonomy
extracellular spaceInterferon betaHomo sapiens (human)
extracellular regionInterferon betaHomo sapiens (human)
Golgi membraneHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
endoplasmic reticulumHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
Golgi apparatusHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
plasma membraneHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
cell surfaceHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
ER to Golgi transport vesicle membraneHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
membraneHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
secretory granule membraneHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
phagocytic vesicle membraneHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
early endosome membraneHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
recycling endosome membraneHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
extracellular exosomeHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
lumenal side of endoplasmic reticulum membraneHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
MHC class I protein complexHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
extracellular spaceHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
external side of plasma membraneHLA class I histocompatibility antigen, B alpha chain Homo sapiens (human)
cytosolProstacyclin receptorHomo sapiens (human)
plasma membraneProstacyclin receptorHomo sapiens (human)
plasma membraneProstacyclin receptorHomo sapiens (human)
virion membraneSpike glycoproteinSevere acute respiratory syndrome-related coronavirus
plasma membraneProstaglandin D2 receptorHomo sapiens (human)
membraneProstaglandin D2 receptorHomo sapiens (human)
plasma membraneProstaglandin D2 receptorHomo sapiens (human)
fibrillar centerInositol hexakisphosphate kinase 1Homo sapiens (human)
nucleoplasmInositol hexakisphosphate kinase 1Homo sapiens (human)
cytosolInositol hexakisphosphate kinase 1Homo sapiens (human)
nucleusInositol hexakisphosphate kinase 1Homo sapiens (human)
cytoplasmInositol hexakisphosphate kinase 1Homo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Bioassays (35)

Assay IDTitleYearJournalArticle
AID1437822Intrinsic activity at recombinant rat IP receptor expressed in CHO-K1 cells assessed as increase in intracellular cAMP level at 10 uM after 1 hr incubation by HTRF method relative to iloprost2017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID1437823Agonist activity at recombinant rat IP receptor expressed in CHO-K1 cells assessed as increase in intracellular cAMP level after 1 hr incubation by HTRF method2017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID309972Hydrolytic rate in Sprague-Dawley rat plasma assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid production per mg of protein at 10 uM2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID1437907Selectivity ratio of EC50 for recombinant rat IP receptor expressed in CHO-K1 cells to EC50 for recombinant human IP receptor expressed in CHO-K1 cells2017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID301228Inhibition of ADP-induced platelet aggregation in human platelet rich plasma2007Bioorganic & medicinal chemistry, Nov-01, Volume: 15, Issue:21
Structure-activity studies on diphenylpyrazine derivatives: a novel class of prostacyclin receptor agonists.
AID309984Tmax in cynomolgus monkey assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid level at 1 mg/kg, po2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID1437906Ratio of IC50 for IP receptor in human primary platelets to EC50 for recombinant human IP receptor expressed in CHO-K1 cells2017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID309976Hydrolytic rate in human hepatic microsomes assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid production per mg of protein at 10 uM2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID309977Hydrolytic rate in cynomolgus monkey hepatic microsomes assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid production in presence of 10 uM PMSF relative to control2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID309986Half life in cynomolgus monkey assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid at 1 mg/kg, po2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID309983AUC (0 to 24 hrs) in cynomolgus monkey at 1 mg/kg, po2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID309985Cmax in cynomolgus monkey assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid level at 1 mg/kg, po2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID309975Hydrolytic rate in cynomolgus monkey hepatic microsomes assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid production per mg of protein at 10 uM2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID309973Hydrolytic rate in Sprague-Dawley rat hepatic microsomes assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid production per mg of protein at 10 uM2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID1437825Agonist activity at recombinant human IP receptor expressed in CHO-K1 cells assessed as increase in intracellular cAMP level after 1 hr incubation by HTRF method2017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID309980Tmax in cynomolgus monkey at 1 mg/kg, po2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID1437830Half life in rat microsomes2017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID309979Hydrolytic rate in cynomolgus monkey hepatic microsomes assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid production in presence of 1000 uM PMSF relative to control2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID1437828Agonist activity at IP receptor in human primary platelets assessed as inhibition of ADP-induced platelet aggregation2017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID1437826Agonist activity at recombinant human DP1 receptor expressed in CHO-K1 cells assessed as increase in intracellular cAMP level after 1 hr incubation by HTRF method2017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID309987AUC (0 to 24 hrs) in cynomolgus monkey assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid at 1 mg/kg, po2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID1437829Half life in human microsomes2017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID1437824Intrinsic activity at recombinant human IP receptor expressed in CHO-K1 cells assessed as increase in intracellular cAMP level at 10 uM after 1 hr incubation by HTRF method relative to iloprost2017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID309978Hydrolytic rate in cynomolgus monkey hepatic microsomes assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid production in presence of 100 uM PMSF relative to control2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID309981Cmax in cynomolgus monkey at 1 mg/kg, po2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID309982Half life in cynomolgus monkey at 1 mg/kg, po2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID1437827Intrinsic activity at recombinant human DP1 receptor expressed in CHO-K1 cells assessed as increase in intracellular cAMP level after 1 hr incubation by HTRF method relative to prostaglandin D22017Journal of medicinal chemistry, 02-09, Volume: 60, Issue:3
Discovery of 2-(((1r,4r)-4-(((4-Chlorophenyl)(phenyl)carbamoyl)oxy)methyl)cyclohexyl)methoxy)acetate (Ralinepag): An Orally Active Prostacyclin Receptor Agonist for the Treatment of Pulmonary Arterial Hypertension.
AID309974Hydrolytic rate in Beagle dog hepatic microsomes assessed as 2-(4-((5,6-diphenylpyrazin-2-yl)(isopropyl)amino)butoxy)acetic acid production per mg of protein at 10 uM2007Bioorganic & medicinal chemistry, Dec-15, Volume: 15, Issue:24
Synthesis and evaluation of N-acylsulfonamide and N-acylsulfonylurea prodrugs of a prostacyclin receptor agonist.
AID1347160Primary screen NINDS Rhodamine qHTS for Zika virus inhibitors2020Proceedings of the National Academy of Sciences of the United States of America, 12-08, Volume: 117, Issue:49
Therapeutic candidates for the Zika virus identified by a high-throughput screen for Zika protease inhibitors.
AID1296008Cytotoxic Profiling of Annotated Libraries Using Quantitative High-Throughput Screening2020SLAS discovery : advancing life sciences R & D, 01, Volume: 25, Issue:1
Cytotoxic Profiling of Annotated and Diverse Chemical Libraries Using Quantitative High-Throughput Screening.
AID1346986P-glycoprotein substrates identified in KB-3-1 adenocarcinoma cell line, qHTS therapeutic library screen2019Molecular pharmacology, 11, Volume: 96, Issue:5
A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
AID1347159Primary screen GU Rhodamine qHTS for Zika virus inhibitors: Unlinked NS2B-NS3 protease assay2020Proceedings of the National Academy of Sciences of the United States of America, 12-08, Volume: 117, Issue:49
Therapeutic candidates for the Zika virus identified by a high-throughput screen for Zika protease inhibitors.
AID1346987P-glycoprotein substrates identified in KB-8-5-11 adenocarcinoma cell line, qHTS therapeutic library screen2019Molecular pharmacology, 11, Volume: 96, Issue:5
A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
AID1346350Human IP receptor (Prostanoid receptors)2007The Journal of pharmacology and experimental therapeutics, Sep, Volume: 322, Issue:3
2-[4-[(5,6-diphenylpyrazin-2-yl)(isopropyl)amino]butoxy]-N-(methylsulfonyl)acetamide (NS-304), an orally available and long-acting prostacyclin receptor agonist prodrug.
AID1346331Rat IP receptor (Prostanoid receptors)2007The Journal of pharmacology and experimental therapeutics, Sep, Volume: 322, Issue:3
2-[4-[(5,6-diphenylpyrazin-2-yl)(isopropyl)amino]butoxy]-N-(methylsulfonyl)acetamide (NS-304), an orally available and long-acting prostacyclin receptor agonist prodrug.
[information is prepared from bioassay data collected from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (139)

TimeframeStudies, This Drug (%)All Drugs %
pre-19900 (0.00)18.7374
1990's0 (0.00)18.2507
2000's4 (2.88)29.6817
2010's83 (59.71)24.3611
2020's52 (37.41)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Market Indicators

Research Demand Index: 72.12

According to the monthly volume, diversity, and competition of internet searches for this compound, as well the volume and growth of publications, there is estimated to be very strong demand-to-supply ratio for research on this compound.

MetricThis Compound (vs All)
Research Demand Index72.12 (24.57)
Research Supply Index5.20 (2.92)
Research Growth Index6.28 (4.65)
Search Engine Demand Index120.70 (26.88)
Search Engine Supply Index2.00 (0.95)

This Compound (72.12)

All Compounds (24.57)

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials32 (21.62%)5.53%
Reviews28 (18.92%)6.00%
Case Studies18 (12.16%)4.05%
Observational5 (3.38%)0.25%
Other65 (43.92%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (27)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
A Prospective, Open-label, Platform Study for Long-term Follow-up of Participants Using Study Intervention in Pulmonary Hypertension Parent Studies [NCT05179876]Phase 3230 participants (Anticipated)Interventional2022-05-04Recruiting
A Multicenter, Single-arm, Open-label, Long-term Follow-up Safety Study of Selexipag in Participants Who Participated in a Previous Selexipag Study [NCT04565990]Phase 343 participants (Actual)Interventional2021-05-03Active, not recruiting
A Randomized, Multicenter, Double-Blind, Placebo-Controlled, Parallel-Group Study With Open-Label Extension Period to Assess the Efficacy and Safety of Selexipag as Add-On Treatment to Standard of Care in Children Aged >=2 to <18 Years With Pulmonary Arte [NCT04175600]Phase 3138 participants (Actual)Interventional2020-01-16Active, not recruiting
A Single-center, Open-label, Two-treatment, One-sequence, Cross-over Study to Investigate the Effect of Clopidogrel on the Pharmacokinetics of Selexipag and Its Active Metabolite, ACT-333679, in Healthy Male Subjects [NCT03496506]Phase 122 participants (Actual)Interventional2018-03-05Completed
A Multi-center, Double-blind, Placebo-controlled Phase 4 Study in Patients With Pulmonary Arterial Hypertension to Assess the Effect of Selexipag on Daily Life Physical Activity and Patient's Self-reported Symptoms and Their Impacts [NCT03078907]Phase 4108 participants (Actual)Interventional2017-11-08Completed
A Multi-center, Double-blind, Randomized, Placebo-controlled, Parallel Group, Exploratory Phase 2 Study to Assess Efficacy and Safety of Selexipag in Adult Subjects With Raynaud's Phenomenon Secondary to Systemic Sclerosis [NCT02260557]Phase 274 participants (Actual)Interventional2014-10-31Completed
Single-center, Double-blind, Randomized, Placebo- and Positive-controlled, Parallel-group With Nested Cross-over, Multiple-dose, Up-titration Study of the Effects of Selexipag and Its Metabolite ACT-333679 on Cardiac Repolarization in Healthy Male and Fem [NCT02206204]Phase 1159 participants (Actual)Interventional2012-06-30Completed
A Multicentre Randomised Cross-over Trial of Disease Specific Therapy in Patients With Pulmonary Arterial Hypertension (PAH) Implanted With Pulmonary Artery Pressure and Cardiac Rhythm Monitoring Devices (CardioMEMS/ConfirmRx) [NCT05825417]Phase 440 participants (Anticipated)Interventional2023-06-14Recruiting
Single-center, Open-label, Randomized, Two-way Crossover Study in Healthy Adult Male Subjects to Compare the Pharmacokinetics of Selexipag (ACT-293987) Following Single Oral Administration of 4 Film-coated Pediatric Tablets of 50 µg vs One Film-coated Tab [NCT02745860]Phase 120 participants (Actual)Interventional2016-06-30Completed
Pulmonary Arterial Hypertension Quality Enhancement Research Initiative Extension Program [NCT01389206]797 participants (Actual)Observational [Patient Registry]2011-06-01Completed
A Single-center, Open-label, Randomized, Formulation Screening, Two-cohort, Four-period, Crossover Study for Selexipag Sustained Release in Healthy Male Subjects [NCT04266756]Phase 124 participants (Actual)Interventional2020-01-23Completed
A Single-center, Open-label, Randomized, Two-treatment Crossover Study to Investigate the Effect of Selexipag on the Pharmacokinetics of Midazolam and Its Metabolite 1-hydroxymidazolam in Healthy Male Subjects [NCT02791815]Phase 120 participants (Actual)Interventional2016-07-31Completed
A Prospective, Multicenter, Single-Arm, Open-Label, Phase 4 Study of the Effects of Selexipag on Right Ventricular Remodeling in Pulmonary Arterial Hypertension Assessed by Cardiac Magnetic Resonance Imaging [NCT04435782]Phase 49 participants (Actual)Interventional2021-07-07Terminated(stopped due to The Sponsor decided to prematurely terminate the study due to the lower-than-expected recruitment rate.)
A Single-center, Open-label, Randomized, Two-period, Two-treatment, Crossover Study in Healthy Male Subjects to Demonstrate Bioequivalence of 1600 μg Selexipag Administered as Eight Tablets of 200 μg (Reference Drug) or as Single Tablet of 1600 μg (Test D [NCT02206295]Phase 180 participants (Actual)Interventional2012-09-30Completed
A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study in Participants With Sarcoidosis-Associated Pulmonary Hypertension (SAPH) to Assess the Efficacy and Safety of Oral Selexipag. [NCT03942211]Phase 210 participants (Actual)Interventional2021-02-26Completed
Selexipag for the Treatment of Schistosomiasis-Associated Pulmonary Arterial Hypertension [NCT04589390]Phase 220 participants (Anticipated)Interventional2020-10-15Recruiting
Single-center, Open-label, Phase 1 Study Consisting of a Single-dose Pilot Phase and a Randomized, Two-way Crossover, Single-dose Main Phase to Investigate the Absolute Bioavailability of a Single Oral Dose of Selexipag in Healthy Male Subjects [NCT02882425]Phase 119 participants (Actual)Interventional2015-01-31Completed
A Multicenter, Double-blind, Placebo-controlled Phase 3 Study Assessing the Safety and Efficacy of Selexipag on Morbidity and Mortality in Patients With Pulmonary Arterial Hypertension [NCT01106014]Phase 31,156 participants (Actual)Interventional2009-12-01Completed
A Single-center, Open-label, Randomized, Two-part, Two-treatment, Two-period Crossover Study to Investigate the Effect of Gemfibrozil or Rifampicin on the Pharmacokinetics of Selexipag and Its Metabolite ACT-333679 in Healthy Male Subjects. [NCT02770222]Phase 140 participants (Actual)Interventional2016-06-30Completed
A Prospective, Multicenter, Open Label, Single Arm, Phase 2 Study to Investigate the Safety, Tolerability and Pharmacokinetics of Selexipag in Children With Pulmonary Arterial Hypertension [NCT03492177]Phase 263 participants (Actual)Interventional2018-07-23Active, not recruiting
A Multicenter, Open-label, Single-sequence Cross-over Study to Assess Safety, Tolerability, and Pharmacokinetics of Intravenous Selexipag in Subjects With Stable Pulmonary Arterial Hypertension Switching From an Oral Stable Dose of Selexipag [NCT03187678]Phase 320 participants (Actual)Interventional2017-12-04Completed
A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group, Group-sequential, Adaptive, Phase 3 Study With Open-label Extension Period to Assess the Efficacy and Safety of Selexipag as an add-on to Standard of Care Therapy in Subjects Wit [NCT03689244]Phase 3128 participants (Actual)Interventional2019-01-23Terminated(stopped due to The study did not demonstrate efficacy on the primary endpoint, PVR vs. placebo at wk 20 at a planned interim analysis.)
A Multi-centre, Multinational, Open-label, Single-dose Acute Hemodynamic Study Followed by Multi-centre, Multinational, Randomized, Double-blind, Parallel-group, Placebo Controlled Study to Assess the Safety, Tolerability, Pharmacokinetics and Preliminary [NCT00993408]Phase 243 participants (Actual)Interventional2008-04-30Completed
The Efficacy and Safety of Initial Triple Versus Initial Dual Oral Combination Therapy in Patients With Newly Diagnosed Pulmonary Arterial Hypertension: A Multi-center, Double-blind, Placebo-controlled, Phase 3b Study [NCT02558231]Phase 3247 participants (Actual)Interventional2016-05-01Completed
Multicenter, Open-label, Single-group Study to Assess the Tolerability and the Safety of the Transition From Inhaled Treprostinil to Oral Selexipag in Adult Patients With Pulmonary Arterial Hypertension [NCT02471183]Phase 334 participants (Actual)Interventional2015-10-12Completed
Long-term Single-arm Open-label Study, to Assess the Safety and Tolerability of ACT-293987 in Patients With Pulmonary Arterial Hypertension [NCT01112306]Phase 3709 participants (Actual)Interventional2010-07-07Completed
Individual Patient Expanded Access IND for Selexipag (Uptravi) in Participants With Non-healing Wound, Buerger's Disease [NCT04914247]0 participants Expanded AccessAvailable
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

TrialOutcome
NCT01106014 (3) [back to overview]Absence of Worsening From Baseline to Week 26 in Modified NYHA/WHO Functional Class (WHO FC)
NCT01106014 (3) [back to overview]Change From Baseline to Week 26 in 6-minute Walk Distance (6MWD) at Trough
NCT01106014 (3) [back to overview]Time From Randomization to the First Morbidity Event or Death (All Causes) up to 7 Days After the Last Study Drug Intake
NCT01112306 (4) [back to overview]Number of Participants With Treatment-emergent Serious Adverse Events (SAEs) up to 3 Days After Study Intervention Discontinuation
NCT01112306 (4) [back to overview]Number of Participants With Treatment-emergent Adverse Events (TEAEs) up to 3 Days After Study Intervention Discontinuation
NCT01112306 (4) [back to overview]Number of Participants With TEAEs Leading to Permanent Discontinuation of Study Intervention
NCT01112306 (4) [back to overview]Percentage of Alive Participants
NCT02471183 (12) [back to overview]Geometric Mean of the Ratio in N-terminal Pro B-type Natriuretic Peptide (NT-proBNP) of Week 16 to Baseline
NCT02471183 (12) [back to overview]Percentage of Patients With Change in 6-minute Walk Distance (6MWD)
NCT02471183 (12) [back to overview]Percentage of Subjects With Treatment-emergent Adverse Events (AEs),
NCT02471183 (12) [back to overview]Percentage of Subjects With WHO Functional Class (FC) Change From Baseline
NCT02471183 (12) [back to overview]Change From Baseline to Week 16 in the Treatment Satisfaction Questionnaire for Medication Questionnaire (TSQM II)
NCT02471183 (12) [back to overview]Absolute Change From Baseline Over Time in Heart Rate (HR)
NCT02471183 (12) [back to overview]Absolute Change From Baseline Over Time in Blood Pressure
NCT02471183 (12) [back to overview]Time to Discontinuation of Inhaled Treprostinil.
NCT02471183 (12) [back to overview]Percentage of Subjects With Sustained Treatment Transition
NCT02471183 (12) [back to overview]Number of Subjects With Adverse Events Leading to Premature Discontinuation of Selexipag
NCT02471183 (12) [back to overview]Maximal Tolerated Dose
NCT02471183 (12) [back to overview]Absolute Change in 6-minute Walk Distance (6MWD) at Trough
NCT02558231 (10) [back to overview]Number of Participants With Disease Progression Event
NCT02558231 (10) [back to overview]Change From Baseline to Week 26 in Mean Pulmonary Arterial Pressure (mPAP)
NCT02558231 (10) [back to overview]Change From Baseline to Week 26 in 6-minute Walk Distance (6MWD)
NCT02558231 (10) [back to overview]Change From Baseline to Week 26 in Cardiac Index
NCT02558231 (10) [back to overview]Change From Baseline to Week 26 in Venous Oxygen Saturation (%)
NCT02558231 (10) [back to overview]Change From Baseline to Week 26 in Mean Right Atrial Pressure (mRAP)
NCT02558231 (10) [back to overview]Change From Baseline to Week 26 in N-terminal Pro B-type Natriuretic Peptide (NT-proBNP) Levels
NCT02558231 (10) [back to overview]Change From Baseline to Week 26 in Pulmonary Vascular Resistance (PVR)
NCT02558231 (10) [back to overview]Change From Baseline to Week 26 in Total Pulmonary Resistance
NCT02558231 (10) [back to overview]Percentage of Participants With Absence of Worsening From Baseline to Week 26 in World Health Organization (WHO) Functional Class (FC)
NCT03078907 (11) [back to overview]Change From Baseline to Week 24 in 6-Minute Walk Distance (6MWD)
NCT03078907 (11) [back to overview]Number of Participants With Change From Baseline to Week 24 in World Health Organization Functional Class (WHO FC)
NCT03078907 (11) [back to overview]Change From Baseline to Week 24 in Pulmonary Arterial Hypertension-Symptoms and Impact (PAH-SYMPACT) Score
NCT03078907 (11) [back to overview]Change From Baseline to Week 24 in Actigraphy DLPA for Variables Expressed in Percentage (%)
NCT03078907 (11) [back to overview]Change From Baseline to Week 24 in Actigraphy DLPA for Variables Expressed in Counts Per Minute (Counts/Minute)
NCT03078907 (11) [back to overview]Change From Baseline to Week 24 in N-Terminal Pro B-type Natriuretic Peptide (NT-proBNP)
NCT03078907 (11) [back to overview]Change From Baseline to Week 24 in Actigraphy Assessed Daily Life Physical Activity (DLPA) for Variables Expressed in Minutes
NCT03078907 (11) [back to overview]Change From Baseline to Week 24 in Borg Dyspnea Score
NCT03078907 (11) [back to overview]Change From Baseline to Week 24 in Actigraphy DLPA for Variables Expressed in Step Counts/Minute
NCT03078907 (11) [back to overview]Change From Baseline to Week 24 in Actigraphy DLPA for Variables Expressed in Counts
NCT03078907 (11) [back to overview]Change From Baseline to Week 24 in Actigraphy DLPA for Variable Expressed in Step Counts
NCT03187678 (5) [back to overview]Number of Participants With Prostacyclin-associated Adverse Events
NCT03187678 (5) [back to overview]Number of Participants With Prostacyclin-associated AEs Leading to Study Treatment Discontinuation
NCT03187678 (5) [back to overview]Number of Participants With PAH-related Adverse Events
NCT03187678 (5) [back to overview]Number of Participants With at Least One Adverse Event (AE)
NCT03187678 (5) [back to overview]Number of Participants With Adverse Event Related to Injection Site Reactions
NCT03492177 (1) [back to overview]Area Under the Plasma Concentration-time Curve Over a Dose Interval at Steady State of Selexipag and Its Metabolite ACT-333679 Combined (AUCτ, ss, Combined)
NCT03689244 (1) [back to overview]Change From Baseline in Pulmonary Vascular Resistance (PVR) at Week 20

Absence of Worsening From Baseline to Week 26 in Modified NYHA/WHO Functional Class (WHO FC)

(NCT01106014)
Timeframe: Week 26

InterventionPercentage of patients (Number)
Selexipag77.8
Placebo74.9

[back to top]

Change From Baseline to Week 26 in 6-minute Walk Distance (6MWD) at Trough

The 6-minute walk distance test (6MWD) is a non-encouraged test performed in a 30 m long flat corridor, where the patient is instructed to walk as far as possible, back and forth around two cones, with the permission to slow down, rest, or stop if needed. If the patient was used to taking bronchodilators before a walk, he/she was given them 5 to 30 min before the test. Also if the patient was on chronic oxygen therapy, oxygen was given at their standard rate during the test. Absolute change from baseline to Week 26 in 6MWD was measured at trough, i.e., either on the next day after the last study drug administration or at least 12 hours after study drug administration if on the same day. (NCT01106014)
Timeframe: Week 26

,
InterventionMeters (Median)
6MWD at baseline - Overall6MWD at Week 26- Overall6MWD Change from baseline at Week 26
Placebo369346-9
Selexipag3763704

[back to top]

Time From Randomization to the First Morbidity Event or Death (All Causes) up to 7 Days After the Last Study Drug Intake

"Time from randomization to the first occurrence of a morbidity event or death (all causes) was analyzed with the Kaplan-Meier method (event-free KM estimates at different time points).~Morbidity event was defined as any of the following events confirmed by the Critical Event committee:~Hospitalization for worsening of pulmonary arterial hypertension (PAH),~Worsening of PAH resulting in need for lung transplantation or balloon atrial septostomy,~Initiation of parenteral prostanoid therapy or chronic oxygen therapy due to worsening of PAH,~Disease progression which was defined by a decrease in 6-minute walk distance from baseline (>=15%, confirmed by a 2nd test on a different day) combined with worsening of WHO FC for patients belonging to WHO FC II/III at baseline, or combined with the need for additional PAH-specific therapy for patients belonging to WHO FC III/IV at baseline.~Note: The number of patients at risk decreased over time but this cannot be captured below" (NCT01106014)
Timeframe: Up to 7 days after end of double-blind treatment (maximum: 4.3 years)

,
InterventionPercentage of patients free of events (Number)
KM estimate at Month 6KM estimate at Month 12KM estimate at Month 18KM estimate at Month 24KM estimate at Month 30KM estimate at Month 36
Placebo81.770.661.353.949.341.7
Selexipag91.283.175.567.961.958.2

[back to top]

Number of Participants With Treatment-emergent Serious Adverse Events (SAEs) up to 3 Days After Study Intervention Discontinuation

An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. SAE is any AE that results in: death, persistent or significant disability/incapacity, requires inpatient hospitalization or prolongation of existing hospitalization, is life-threatening experience, is a congenital anomaly/birth defect and may jeopardize participant and/or may require medical or surgical intervention to prevent one of the outcomes listed above. Those SAEs occurring during study drug administration, that is, between study drug initiation and three days after study drug discontinuation, are defined as treatment-emergent SAEs. (NCT01112306)
Timeframe: Up to 3 days after study drug discontinuation (Up to 10.5 years)

InterventionParticipants (Count of Participants)
Selexipag420

[back to top]

Number of Participants With Treatment-emergent Adverse Events (TEAEs) up to 3 Days After Study Intervention Discontinuation

An adverse event (AE) is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. A TEAE is any AE temporally associated with the use of study drug (from study drug initiation until 3 days after study drug discontinuation), whether or not considered related to the study drug. (NCT01112306)
Timeframe: Up to 3 days after study drug discontinuation (Up to 10.5 years)

InterventionParticipants (Count of Participants)
Selexipag684

[back to top]

Number of Participants With TEAEs Leading to Permanent Discontinuation of Study Intervention

An adverse event (AE) is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. A TEAE is any AE temporally associated with the use of study drug (from study drug initiation until 3 days after study drug discontinuation), whether or not considered related to the study drug. (NCT01112306)
Timeframe: Up to 10.5 years

InterventionParticipants (Count of Participants)
Selexipag129

[back to top]

Percentage of Alive Participants

Percentage of alive participants were analyzed using Kaplan-Meier (KM) estimates. (NCT01112306)
Timeframe: Baseline (Day 1), Months 3, 6, 9, 12, 24, 36, 48, 60, 72, 84, 96, 108, and 120

InterventionPercentage of participants (Number)
KM estimate at Baseline (Day 1)KM estimate at Month 3KM estimate at Month 6KM estimate at Month 9KM estimate at Month 12KM estimate at Month 24KM estimate at Month 36KM estimate at Month 48KM estimate at Month 60KM estimate at Month 72KM estimate at Month 84KM estimate at Month 96KM estimate at Month 108KM estimate at Month 120
Selexipag10098.496.394.092.085.379.375.271.266.863.360.356.956.9

[back to top]

Geometric Mean of the Ratio in N-terminal Pro B-type Natriuretic Peptide (NT-proBNP) of Week 16 to Baseline

Changes in NT-proBNP levels in plasma are expressed by the geometric mean of the ratio of Week 16 to baseline (NCT02471183)
Timeframe: Baseline and Week 16

InterventionGeometric mean of the ratio (Geometric Mean)
Selexipag1.1

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Percentage of Patients With Change in 6-minute Walk Distance (6MWD)

"Percentage of patients with an increase (> 8% of baseline), maintenance (+/- 8% of baseline), or decrease (< -8% of baseline) in their 6MWD (at trough) from baseline to Week 16. The ± 8% boundaries for change in 6MWD reflect the approximately 8% coefficient of variation in the reproducibility of the 6MWD.~The trough level of inhaled treprostinil is defined as the last dose having been taken not less than 4 hours and not more than 48 hours prior to the 6MWD test at Visit 1 (screening). The trough level of selexipag was defined as the last dose having been taken not less than 8 hours and not more than 7 days prior to the 6MWD test at Visit 5 (Week 16)." (NCT02471183)
Timeframe: Baseline and Week 16

InterventionPercentage of participants (Number)
6MWD decreased6MWD maintained6MWD increased
Selexipag26.555.917.6

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Percentage of Subjects With Treatment-emergent Adverse Events (AEs),

Percentage of subjects with treatment-emergent AEs (serious and non serious), regardless of relationship to selexipag (NCT02471183)
Timeframe: 26 weeks on average (from the first dose of selexipag up to 30 days after the last dose of selexipag)

InterventionPercentage of participants (Number)
Selexipag97.1

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Percentage of Subjects With WHO Functional Class (FC) Change From Baseline

"The World Health Organization (WHO) defines 4 classes to classify the functional status of patients with pulmonary hypertension:~Class I (FC I): No limitation of physical activity. Class II (FC II): Slight limitation of physical activity. Class III (FC III): Marked limitation of physical activity. Class IV (FC IV): Inability to carry out any physical activity without symptoms.~Number of patients with improvement (shift from a higher to a lower class), worsening (shift from a lower to a higher class) or no change in WHO functional class at end of study compared to baseline are determined." (NCT02471183)
Timeframe: Baseline and Week 16

Interventionpercentage of participants (Number)
% subjects with WHO FC improvement% subjects with WHO FC worsening% subjects with WHO FC unchanged
Selexipag26.55.967.6

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Change From Baseline to Week 16 in the Treatment Satisfaction Questionnaire for Medication Questionnaire (TSQM II)

"The Treatment Satisfaction Questionnaire for Medication, Version II (TSQM II) is a validated tool that evaluate the subject's satisfaction with the study treatment. It includes a total of 11 questions related to satisfaction with treatment effectiveness, side effects,convenience, and global satisfaction.~TSQM scores range from 0 to 100 for each domain; a higher score indicates higher satisfaction with treatment." (NCT02471183)
Timeframe: Baseline and Week 16

InterventionUnits on a scale (Median)
Effectiveness (change from baseline)Side effects (change from baseline)Convenience (change from baseline)Global satisfaction (change from baseline)
Selexipag0.000.0044.448.33

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Absolute Change From Baseline Over Time in Heart Rate (HR)

Pulse rate is measured after at least 5 minutes of rest in a sitting position. Median change from baseline to pre-specified post-baseline visits are calculated. (NCT02471183)
Timeframe: Baseline, Week 4, Week 12, Week 16

Interventionbeats per minute (bpm) (Median)
HR change from baseline at week 4HR change from baseline at week 12HR change from baseline at week 16
Selexipag4.006.003.00

[back to top]

Absolute Change From Baseline Over Time in Blood Pressure

Both systolic(SBP) and diastolic (DBP) arterial blood pressure were measured in a sitting position after at least 5 minutes of rest at scheduled time points. Median change from baseline to pre-specified post-baseline visits are calculated (NCT02471183)
Timeframe: Baseline, Week 4, Week 12, Week 16

InterventionmmHg (Median)
SBP change from baseline at week 4SBP change from baseline at week 12SBP change from baseline at week 16DBP change from baseline at week 4DBP change from baseline at week 12DBP change from baseline at week 16
Selexipag1.00-3.00-4.00-3.00-4.00-6.00

[back to top]

Time to Discontinuation of Inhaled Treprostinil.

Median time from baseline (Day1) to the end of down-titration of inhaled treprostinil is calculated (NCT02471183)
Timeframe: Baseline to Week 16

Interventionweeks (Median)
Selexipag6.21

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Percentage of Subjects With Sustained Treatment Transition

"A sustained treatment transition is considered if the 3 following criteria are met a) being on study treatment (selexipag) at Week 16, and b) not having a study treatment interruption(s) of a total of 8 days or more prior to Week 16, and c) absence of inhaled treprostinil or any prostanoid treatment after Week 8 up to Week 16.~The percentage of subjects with a sustained treatment transition is calculated with 95% confidence interval (CI) using the Clopper-Pearson method." (NCT02471183)
Timeframe: At Week 16

InterventionPercentage of participants (Number)
Selexipag82.4

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Number of Subjects With Adverse Events Leading to Premature Discontinuation of Selexipag

Number of subjects with adverse events leading to premature discontinuation of selexipag is determined from the first dose of selexipag up to the last dose of selexipag (NCT02471183)
Timeframe: Up to 22 weeks on average

InterventionParticipants (Count of Participants)
Selexipag3

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Maximal Tolerated Dose

"This is the individual maximal tolerated dose (MTD) observed at Week 12 in the subjects still on selexipag at Week 16.~MTD is defined as the dose of selexipag reached with the last dose change up to Week 12" (NCT02471183)
Timeframe: At Week 12, in subjects still on selexipag at Week 16

Interventionmcg (Median)
Selexipag1200

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Absolute Change in 6-minute Walk Distance (6MWD) at Trough

"The 6MWT is a non-encouraged test, which measures the distance (in meters) covered by the subject during a 6-minute walk. It is performed in a 30-meters long flat corridor, where the patient is instructed to walk as far as possible, back and forth around two cones, with the permission to slow down, rest, or stop if needed.~Absolute change from baseline to Week 16 in 6MWD is measured at trough levels of inhaled treprostinil and/or selexipag. The trough level of inhaled treprostinil is defined as the last dose having been taken not less than 4 hours and not more than 48 hours prior to the 6MWT at Visit 1 (screening). The trough level of selexipag was defined as the last dose having been taken not less than 8 hours and not more than 7 days prior to the 6MWT at Visit 5 (Week 16)." (NCT02471183)
Timeframe: Baseline and Week 16

Interventionmeters (Median)
Selexipag-10.25

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Number of Participants With Disease Progression Event

Number of participants with disease progression event were reported. Disease progression event as adjudicated by the CEC, defined as any of the following: a. Death (all causes; adjudicated for PAH relationship); b. Hospitalization for worsening PAH; c. Initiation of prostacyclin, a prostacyclin analog, or a prostacyclin receptor agonist for worsening PAH; d. Clinical worsening defined as a post-baseline decrease in 6MWD by more than (>) 15 percent (%) from the highest 6MWD obtained at or after baseline, accompanied by WHO FC III or IV (both conditions confirmed at two consecutive post-baseline visits separated by 1-21 days). (NCT02558231)
Timeframe: Week 26, Month 12, Month 18, Month 24, Month 30, and End of Analysis Period (up to 40 months)

,
InterventionParticipants (Count of Participants)
Week 26Month 12Month 18Month 24Month 30End of Analysis Period (up to 40 months)
Double Oral Therapy (Macitentan, Tadalafil, and Placebo)132023252727
Triple Oral Therapy (Macitentan, Tadalafil, and Selexipag)81315151616

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Change From Baseline to Week 26 in Mean Pulmonary Arterial Pressure (mPAP)

Change from baseline to Week 26 in mean Pulmonary Arterial Pressure (mPAP) was measured. The pulmonary artery pressure is a measure of the blood pressure found in the main pulmonary artery. Missing values were imputed using a LOCF approach. (NCT02558231)
Timeframe: Baseline, Week 26

Interventionmillimeters of mercury (mmHg) (Least Squares Mean)
Triple Oral Therapy (Macitentan, Tadalafil, and Selexipag)-12.92
Double Oral Therapy (Macitentan, Tadalafil, and Placebo)-12.20

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Change From Baseline to Week 26 in 6-minute Walk Distance (6MWD)

The change from baseline to Week 26 in 6MWD was calculated as Week 26 minus baseline. The test measures the distance an individual is able to walk over a total of six minutes on a hard, flat surface. The goal is for the individual to walk as far as possible in six minutes. Missing values were imputed using a LOCF approach. (NCT02558231)
Timeframe: Baseline, Week 26

Interventionmeter (Least Squares Mean)
Triple Oral Therapy (Macitentan, Tadalafil, and Selexipag)54.96
Double Oral Therapy (Macitentan, Tadalafil, and Placebo)56.39

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Change From Baseline to Week 26 in Cardiac Index

Change from baseline to Week 26 in cardiac index was measured. Cardiac index is the amount of blood pumped by the heart, per minute, per meter square of body surface area. Re-calculated values were used for analysis and missing values were imputed using a LOCF approach. (NCT02558231)
Timeframe: Baseline, Week 26

Interventionliters per minute per meter square (Least Squares Mean)
Triple Oral Therapy (Macitentan, Tadalafil, and Selexipag)0.97
Double Oral Therapy (Macitentan, Tadalafil, and Placebo)0.84

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Change From Baseline to Week 26 in Venous Oxygen Saturation (%)

Change from baseline to Week 26 in venous oxygen saturation was measured. Missing values were imputed using a LOCF approach. (NCT02558231)
Timeframe: Baseline, Week 26

Interventionpercentage of oxygen saturation (Least Squares Mean)
Triple Oral Therapy (Macitentan, Tadalafil, and Selexipag)5.59
Double Oral Therapy (Macitentan, Tadalafil, and Placebo)6.79

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Change From Baseline to Week 26 in Mean Right Atrial Pressure (mRAP)

Change from baseline to Week 26 in mean Right Atrial Pressure (mRAP) was measured. Missing values were imputed using a LOCF approach. (NCT02558231)
Timeframe: Baseline, Week 26

InterventionmmHg (Least Squares Mean)
Triple Oral Therapy (Macitentan, Tadalafil, and Selexipag)-1.78
Double Oral Therapy (Macitentan, Tadalafil, and Placebo)-1.69

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Change From Baseline to Week 26 in N-terminal Pro B-type Natriuretic Peptide (NT-proBNP) Levels

The change from baseline to Week 26 in NT-proBNP was expressed as the ratio of Week 26 to baseline NT-proBNP (Week 26 divided by baseline). A geometric least square mean ratio of Week 26 to baseline NT-proBNP <1 corresponds to a reduction in NT-proBNP from baseline. Missing values were imputed using a LOCF approach. (NCT02558231)
Timeframe: Baseline, Week 26

Interventionratio (Geometric Least Squares Mean)
Triple Oral Therapy (Macitentan, Tadalafil, and Selexipag)0.26
Double Oral Therapy (Macitentan, Tadalafil, and Placebo)0.25

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Change From Baseline to Week 26 in Pulmonary Vascular Resistance (PVR)

Change from baseline to Week 26 in PVR was expressed as the ratio of Week 26 to baseline PVR value (Week 26 divided by baseline) using re-calculated PVR. PVR was determined by right heart catheterization (RHC). A geometric least square mean ratio of Week 26 to baseline PVR less than (<) 1 corresponds to a reduction in PVR from baseline. Missing values were imputed using a last observation carried forward (LOCF) approach. (NCT02558231)
Timeframe: Baseline, Week 26

Interventionratio (Geometric Least Squares Mean)
Triple Oral Therapy (Macitentan, Tadalafil, and Selexipag)0.46
Double Oral Therapy (Macitentan, Tadalafil, and Placebo)0.48

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Change From Baseline to Week 26 in Total Pulmonary Resistance

Change from baseline to Week 26 in total pulmonary resistance was measured. Total pulmonary resistance was calculated as mPAP/CO*80, where CO is cardiac output. Re-calculated values were used for analysis and missing values were imputed using a LOCF approach. (NCT02558231)
Timeframe: Baseline, Week 26

Interventiondynes*second per centimeter^5 (Least Squares Mean)
Triple Oral Therapy (Macitentan, Tadalafil, and Selexipag)-511.88
Double Oral Therapy (Macitentan, Tadalafil, and Placebo)-514.28

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Percentage of Participants With Absence of Worsening From Baseline to Week 26 in World Health Organization (WHO) Functional Class (FC)

WHO FC is a classification graded from Class I to IV which reflects disease severity based on symptoms. Worsening was defined as death or hospitalization due to PAH. Class I: No limitation of activity; Class II: slight limitation with ordinary activities; Class III: may not have symptoms at rest but greatly limited activities; Class IV: symptoms at rest and inability to carry out any physical activity without symptoms. Missing values were imputed using a LOCF approach. (NCT02558231)
Timeframe: Week 26

Interventionpercentage of participants (Number)
Triple Oral Therapy (Macitentan, Tadalafil, and Selexipag)99.2
Double Oral Therapy (Macitentan, Tadalafil, and Placebo)97.5

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Change From Baseline to Week 24 in 6-Minute Walk Distance (6MWD)

The 6MWD was the total distance walked during 6 minutes. Mean change from baseline (distance walked at Week 24 minus distance walked at baseline) was reported. (NCT03078907)
Timeframe: Baseline and Week 24

Interventionmeters (Mean)
Selexipag18.3
Placebo9.8

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Number of Participants With Change From Baseline to Week 24 in World Health Organization Functional Class (WHO FC)

"The WHO FC of pulmonary hypertension is a physical activity rating scale as follows: Class I (No limitation of physical activity); Class II (Slight limitation of physical activity); Class III (Marked limitation of physical activity); and Class IV (Inability to carry out any physical activity without symptoms). The change from baseline in WHO FC was classified into Improved, No change and Worsened compared to baseline. Deterioration, No Change, and Improvement are based on shift of risk category (I, II, III, IV) from baseline in WHO Functional Class." (NCT03078907)
Timeframe: Baseline and Week 24

,
InterventionParticipants (Count of Participants)
DeteriorationNo changeImprovement
Placebo14310
Selexipag2339

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Change From Baseline to Week 24 in Pulmonary Arterial Hypertension-Symptoms and Impact (PAH-SYMPACT) Score

"PAH-SYMPACT has 2 main parts: symptoms (cardiopulmonary and cardiovascular) and impact (physical impacts and cognitive/emotional). The symptom part is a questionnaire completed daily for 7 consecutive days and contains 11 items. The impact part has a 7-day recall period and is completed on 7th day of symptoms questionnaire data collection period. It contains 11 items pertaining to impact of PAH. The average Cardiopulmonary Symptoms and cardiovascular symptoms domain scores are determined based on daily scores of 6 and 5 items, respectively, reported on a 5-point Likert scale with score range from 0=best to 4=worst. The Physical impacts and Cognitive/emotional domain consists of 7 items reported on a 5-point Likert scale (from 0 to 4). The value 0 = not at all/with no difficulty at all and value 4 = very much/extremely/ not able at all. Mean value on each of 7-day period was calculated for each specific domain score and corresponding mean change from baseline was reported." (NCT03078907)
Timeframe: Baseline and Week 24

,
Interventionunits on a scale (Mean)
Cardiopulmonary symptomsCardiovascular symptomsPhysical impactCognitive/emotional impact
Placebo-0.080-0.045-0.074-0.090
Selexipag-0.0300.010-0.0430.000

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Change From Baseline to Week 24 in Actigraphy DLPA for Variables Expressed in Percentage (%)

Change from baseline to Week 24 of the DLPA activity parameters for daily time spent in non-sedentary activity (NSA) (Freedson '98), daily time spent in moderate-to-vigorous physical activity (MVPA) (Freedson '98) and dailytime spent in NSA (Koster '16) were reported. These variables were assessed by actigraphy and were expressed in percentage (%). Freedson 1998 established ranges of activity counts obtained from a hip worn accelerometer corresponding to commonly employed MET categories. Based on this work, threshold between sedentary and NSA was defined. This threshold is often referred to as Freedson's 1998 publication. Koster 2016 defined the threshold between sedentary and NSA based on wrist-worn accelerometers on non-dominant hand, respectively. Positive change from baseline means improvement. (NCT03078907)
Timeframe: Baseline and Week 24 (data analysis was done during 14-Days each for Baseline and for Week 24 and mean value reported)

,
InterventionPercentage of daily time spent (Mean)
Daily time spent in NSA (%), Freedson '98Daily time spent in MVPA (%), Freedson '98Daily time spent in NSA (%), Koster '16
Placebo-0.100.320.00
Selexipag0.080.230.80

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Change From Baseline to Week 24 in Actigraphy DLPA for Variables Expressed in Counts Per Minute (Counts/Minute)

Change from baseline to Week 24 of the DLPA activity parameter for total daily activities and NSA (Koster '16) were reported. These variables were assessed by actigraphy and were expressed in counts/minutes. Koster 2016 defined the threshold between sedentary and NSA based on wrist-worn accelerometers on non-dominant hand, respectively. Positive change from baseline means improvement. (NCT03078907)
Timeframe: Baseline and Week 24 (data analysis was done during 14-Days each for Baseline and for Week 24 and mean value reported)

,
Interventioncounts/minute (Mean)
Total daily activitiesNSA, Koster '16
Placebo18.816.8
Selexipag29.336.1

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Change From Baseline to Week 24 in N-Terminal Pro B-type Natriuretic Peptide (NT-proBNP)

Change from baseline to Week 24 in NT-pro BNP levels was reported. The negative change from baseline means improvement. (NCT03078907)
Timeframe: Baseline and Week 24

Interventionnanogram per liter (ng/L) (Mean)
Selexipag-153.8
Placebo81.8

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Change From Baseline to Week 24 in Actigraphy Assessed Daily Life Physical Activity (DLPA) for Variables Expressed in Minutes

Change from baseline to Week 24 of the DLPA activity parameters for daily time spent in non-sedentary activity (NSA) (as defined by Freedson '98 and Koster '16) and daily time spent in moderate-to-vigorous physical activity (MVPA) as defined by Freedson '98 were reported. These variables were assessed by actigraphy and were expressed in minutes. Freedson 1998 established ranges of activity counts obtained from a hip worn accelerometer corresponding to commonly employed MET categories. Based on this work, threshold between sedentary and NSA was defined. This threshold is often referred to as Freedson's 1998 publication. Koster 2016 defined the threshold between sedentary and NSA based on wrist-worn accelerometers on non-dominant hand, respectively. Positive change from baseline means improvement. (NCT03078907)
Timeframe: Baseline and Week 24 (data analysis was done during 14-Days each for Baseline and for Week 24 and mean value reported)

,
Interventionminutes (Mean)
Daily time spent in NSA (Freedson '98)Daily time spent in MVPA (Freedson '98)Daily time spent in NSA (Koster'16)
Placebo-25.2-1.9-15.0
Selexipag-15.20.2-0.7

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Change From Baseline to Week 24 in Borg Dyspnea Score

"The Borg dyspneas score was a self-rating scale to evaluate the severity of dyspnea (from 0 no shortness of breath at all to 10 very, very severe / maximal) shortness of breath. It was completed immediately after the 6-minute walk test at Week 24 and at baseline. Mean change from baseline in scoring was reported." (NCT03078907)
Timeframe: Baseline and Week 24

Interventionunits on a scale (Mean)
Selexipag-0.25
Placebo0.37

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Change From Baseline to Week 24 in Actigraphy DLPA for Variables Expressed in Step Counts/Minute

Change from baseline to Week 24 of the DLPA activity parameters for number of steps during awake time were reported. These variables were assessed by actigraphy and were expressed in step counts/minute. Positive change from baseline means improvement. (NCT03078907)
Timeframe: Baseline and Week 24 (data analysis was done during 14-Days each for Baseline and for Week 24 and mean value reported)

Interventionstep counts/minute (Mean)
Selexipag0.0
Placebo0.0

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Change From Baseline to Week 24 in Actigraphy DLPA for Variables Expressed in Counts

Change from baseline to Week 24 of the DLPA activity parameters for volume of non-sedentary activity (Koster '16)were reported. These variables were assessed by actigraphy and were expressed in counts. Koster 2016 defined the threshold between sedentary and NSA based on wrist-worn accelerometers on non-dominant hand, respectively. Positive change from baseline means improvement. (NCT03078907)
Timeframe: Baseline and Week 24 (data analysis was done during 14-Days each for Baseline and for Week 24 and mean value reported)

Interventioncounts (Mean)
Selexipag3898
Placebo-49187

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Change From Baseline to Week 24 in Actigraphy DLPA for Variable Expressed in Step Counts

Change from baseline to Week 24 of the DLPA activity parameters for number of steps during awake time were reported. These variables were assessed by actigraphy and were expressed in step counts. Positive change from baseline means improvement. (NCT03078907)
Timeframe: Baseline and Week 24 (data analysis was done during 14-Days each for Baseline and for Week 24 and mean value reported)

Interventionstep counts (Mean)
Selexipag-32.4
Placebo-170.9

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Number of Participants With Prostacyclin-associated Adverse Events

Prostacyclin-associated AE include headache, diarrhea, nausea, vomiting, jaw pain, myalgia, pain in the extremity, flushing and arthralgia. (NCT03187678)
Timeframe: From Day 1 to Day 37

InterventionParticipants (Count of Participants)
Selexipag7

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Number of Participants With Prostacyclin-associated AEs Leading to Study Treatment Discontinuation

This is the number of subjects who discontinued the i.v. selexipag treatment due to prostacyclin-associated adverse events (headache, diarrhea, nausea, vomiting, jaw pain, myalgia, pain in the extremity, flushing and arthralgia). (NCT03187678)
Timeframe: From Day 2 to Day 3

InterventionParticipants (Count of Participants)
Selexipag0

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Number of Participants With at Least One Adverse Event (AE)

AE is any untoward medical event that occurs in a participant during the course of the study whether or not considered by the investigator as related to the study treatment. (NCT03187678)
Timeframe: From Day 1 to Day 37

InterventionParticipants (Count of Participants)
Selexipag15

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Area Under the Plasma Concentration-time Curve Over a Dose Interval at Steady State of Selexipag and Its Metabolite ACT-333679 Combined (AUCτ, ss, Combined)

AUCτ, ss, combined was defined as the area under the plasma concentration-time curve over one dosing interval at steady state. AUCτ,ss,combined was calculated as 1/38 AUCτ,ss,selexipag plus 37/38 AUCτ,ss,ACT-333679. (NCT03492177)
Timeframe: Week 1,Week 12: pre-dose, 1, 2, 4, 6, 8 and 12 h post-morning dose. Week 2, 4 and 6: pre-dose (Up to Week 12)

Interventionnanograms*hour per milliliter (Geometric Mean)
Cohort 1 (Greater Than or Equal to [>=] 12 Years to Less Than [<] 18 Years)21.56
Cohort 2 (>=6 to <12 Years)20.40
Cohort 3 (>=2 to <6 Years)18.57

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Change From Baseline in Pulmonary Vascular Resistance (PVR) at Week 20

Change from baseline in PVR at Week 20 was reported. PVR was measured by accessing the vessel either from right heart catheterization or left heart catheterization, if required. Change from baseline in PVR was measured as percent ratio of post treatment value (Week 20) to pre-treatment value (baseline). (NCT03689244)
Timeframe: Baseline (Day 1, pre-dose), within 2 to 5 hours post-dose on Week 20

InterventionPercent ratio (Geometric Least Squares Mean)
Double-blind Period: Placebo89.52
Double-blind Period: Selexipag85.15

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