Chronic Obstructive Pulmonary DiseasePhase 2BETTER COPD-PHNCT05937854
Breathe Easier With Tadalafil Therapy for Dyspnea in COPD-PH
A Phase 2 study testing Tadalafil in people with Chronic Obstructive Pulmonary Disease and Pulmonary Hypertension, run by VA Office of Research and Development at 5 sites in United States.
Trial summary
The investigators will study whether the drug tadalafil improves shortness of breath in 126 Veterans with Chronic Obstructive Pulmonary Disease (COPD) and high blood pressure in the lungs. Read more about this study
- Who is it for?
- Ages 35 to 89 years
- Conditions the study is for
- Chronic Obstructive Pulmonary Disease, Pulmonary Hypertension, Dyspnea
- What is being tested?
- Tadalafil
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 126 participants
- Where
- 5 sitesUnited States
- Study dates
- 1 Apr 2024to 1 Mar 2029
- Phase
- Phase 2
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 35 to 89 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Outpatients with COPD, defined as airflow limitation with post-bronchodilator obstruction on baseline visit spirometry, identified by FEV1/FVC < 70% or < the lower limit of normal (5th percentile of a normal population based on Global Lung Function Initiative reference equations), OR any emphysema on chest CT noted in a clinical radiology report confirmed by study investigator review.
- Eligible subjects must have PH documented as follows:
- Main Pulmonary Artery/Ascending Aorta (PA/A) diameter > 0.90 on clinically available CT scans within 12 months OR
- Main Pulmonary Artery diameter > 30.8mm on clinically available CT scans within 12 months OR
- outpatient echocardiography done within 6 months of enrollment demonstrating PA sys > 34 mmHg OR
- Mean Pulmonary Artery Pressure > 20 on Right Heart Catheterization done within 6 months of enrollment and when Veteran is clinically stable.
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- Eligible subjects must be dyspneic, as quantitated by a score of at least 20 on the baseline UCSD Shortness of Breath Questionnaire, assessed at the time of the baseline visit.
- Treatment with at least one long-acting bronchodilator for at least 4 weeks, assessed at the time of the baseline visit by chart review and patient interview.
- Age 35-89 Years
- Women of childbearing potential must meet one of the following criteria for the previous three months AND must have a negative pregnancy test on the day of testing. If more than 36 hours since the participant's last pregnancy test, they will be tested again at the study visit.
- have been using a contraceptive measure (an intrauterine device (IUD), a contraceptive implant, oral contraceptives, barrier methods, or abstinence)
- have a male partner with a vasectomy
- have a tubal ligation procedure or a medical diagnosis (such as infertility) or therapies/procedures that precludes pregnancy (such as cancer treatments or endometrial ablation)
- are in a same-sex relationship
- have a male partner not capable of fathering children because of congenital anomalies, other surgery, or medical treatment
- Women who are not considered to be of childbearing potential who have been surgically sterilized (for example: removal of ovaries or fallopian tubes, or hysterectomy) or are post-menopausal (no menstrual period for more than 6 months).
Who cannot join
- Diagnosis of PH in the following subgroups of the updated WHO Clinical Classification:
- Group 1 (Idiopathic, heritable, drug- or toxin-induced, Pulmonary Arterial Hypertension associated with connective tissue disease, congenital heart disease)
- Group 2 (left atrial hypertension)
- Group 3 PH not attributable to COPD
- Group 4 (chronic thromboembolic PH) or other forms of PH not associated with primary lung disease.
- Systemic hypotension in the ambulatory setting (at least 3 reproducible measurements of systolic BP <89 mmHg, recorded by a health care provider over 1 week).
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- Moderate or severe hepatic impairment (Child-Pugh B and C).
- Severe renal insufficiency (GFR <30 ml/min/1.73 m2)
- Echocardiography within 6 months showing greater than moderate aortic stenosis (aortic valve area <1.0 cm2), greater than moderate mitral regurgitation, or diastolic dysfunction (Any two of the following: Average E/e' >14, Septal e' velocity < 7 or lateral e' velocity <10, LA volume index > 34 ml/m2). LVEF < 50%. Any aortic or mitral valve replacement.
- Any acute or chronic impairment (other than dyspnea) that limits ability to comply with the study requirements.
- Current unstable angina, myocardial infarction or stroke within 6 months.
- Requirement for nitrate therapy for any clinical indication.
- Active prescription for a PDE-5 inhibitor or other pulmonary vasodilator other than oxygen as a PH treatment.
- History of the following retinal disorders: retinitis pigmentosa, non-arteritic anterior ischemic optic neuropathy, or crowded optic disc noted on ophthalmology examinations recorded in CPRS.
- Contraindications: PDE-5i allergy, penile anatomical deformations, sickle cell anemia, multiple myeloma, leukemia, bleeding disorders, active peptic ulcer disease, retinitis pigmentosa or other retinal disorders listed above. In accordance with 38 USC 7332, this information will be kept confidential and will not be disclosed in presentations, publications, or any other dissemination of the study results, or to anyone outside of the IRB-approved study team.
- Use of any of the following: rifampin, systemic anti-fungal azole agents, protease inhibitors, phenobarbital, dilantin.
- Pregnant, possibly pregnant by report, or if breastfeeding. If found to be pregnant at the study visit, the study visit will not be conducted.
- Pulmonary veno-occlusive disease
- Hypoxia (reproducible ambulatory SaO2 < 90% on supplemental oxygen at rest recorded by a health care provider over 1 week).
- Diagnosis of Obstructive Sleep Apnea without a prescription for treatment.
- Newly prescribed (less than 4 weeks duration) bronchodilator or diuretic therapy or new enrollment in pulmonary rehabilitation at the time of Baseline.
- Students, VA employees, persons with impaired decision making, illiterate and non-English speakers, and terminally ill patients.
- COPD or CHF exacerbation within the past 4 weeks.
- On-going therapy with doxazosin.
- Women of childbearing potential must have a documented negative pregnancy test and must be using adequate contraception during the study and for 9 months afterward. Monthly pregnancy tests will be done, and compliance with contraception use will be documented at the telephone and clinic visits. Should a female become pregnant at any time during the study, the study medication will be discontinued.
- Doxazosin use will be defined as current active prescription and usage of Doxazosin or planned trial (pending prescription) of Doxazosin for treatment of benign prostatic hypertrophy, systemic hypertension, or other indication. A list of alpha-1 antagonists (ex. prazosin, doxazosin, tamulosin, terazosin, etc.) will be included in the patient study medication handout to prompt the patient to avoid any new usage of these drugs during the trial period. On-going therapy with doxazosin is an exclusion criterion due to greater risk of hypotension.
Trial locations and contacts
5 sites in 1 country. Contact the study team or a site near you to ask about taking part.
5 sites in 1 country
United States5 sites, 5 recruiting
- Recruiting
Rocky Mountain Regional VA Medical Center, Aurora, CO
Aurora, Colorado, 80045
Edward Dempsey, MD, 303-399-8020, edward.dempsey@va.gov
Matthew Griffith, MD, 3033998020, matthew.griffith@va.gov
- Recruiting
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
Boston, Massachusetts, 02130-4817
Ronald H Goldstein, MD, 617-323-7700, ronald.goldstein@va.gov
Eric Garshick, 6173237700, eric.garshick@va.gov
- Recruiting
Atlanta VA Medical and Rehab Center, Decatur, GA
Decatur, Georgia, 30033-4004
Cherry Wongtrakool, MD, 404-321-6111, Cherry.wongtrakool@va.gov
Mohleen Kang, MD, 4043216111, Mohleen.kang@va.gov
- Recruiting
Omaha VA Nebraska-Western Iowa Health Care System, Omaha, NE
Omaha, Nebraska, 68105-1850
Ruxana Sadikot, MD, 402-346-8800, ruxana.sadikot2@va.gov
Kristina Bailey, MD, 4023468800, kristina.bailey@va.gov
- Recruiting
Providence VA Medical Center, Providence, RI
Providence, Rhode Island, 02908-4734
Matthew D Jankowich, MD, 401-273-7100, matthew.jankowich@va.gov
Elena R Desanti, MPH, (401) 273-7100 ext. 16505, elena.desanti@va.gov
About this study
Official title: Effect of PDE5 Inhibitor on Respiratory Symptoms in COPD Complicated by Pulmonary Hypertension
The investigators will study whether the drug tadalafil improves shortness of breath in 126 Veterans with Chronic Obstructive Pulmonary Disease (COPD) and high blood pressure in the lungs. The investigators will also assess whether tadalafil improves quality of life, home daily physical activity, exercise endurance, the frequency of acute flares of COPD, blood pressure in the lungs, and lung function. Veterans who enroll in the trial will be allocated by chance to either active tadalafil or an inactive identical capsule (placebo). Neither the Veteran nor the investigator will know whether the Veteran is taking tadalafil or placebo. Veterans will be followed closely in clinic or by telephone at 1, 2, 3, 4, 5, and 6 months, with attention to side effects and safety. At 1,3, and 6 months the investigators will repeat the questionnaires and testing of blood pressures in the lung and lung function. The investigators anticipate that the results of this study will determine whether tadalafil improves shortness of breath when added to usual medications for COPD.
Read the detailed description
Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the US and is common among Veterans. Dyspnea, a debilitating symptom of COPD, dramatically worsens health related quality of life, is associated with a reduction in daily physical activity and greater health care utilization and is more closely associated with survival than severity of airflow limitation. Thus, it is important to have effective treatments that reduce dyspnea for Veterans with COPD. Pulmonary hypertension (PH) is a common complication of COPD that is associated with severe dyspnea, more frequent acute exacerbations of COPD, and increased mortality. There are multiple causes of PH associated with COPD (COPD-PH), including decreased bioavailable levels of the vasodilator nitric oxide (NO). Phosphodiesterase type-5 inhibitor (PDE-5i) therapy restores NO signaling and improves cardiopulmonary hemodynamics and dyspnea among patients with Pulmonary Arterial Hypertension. However, studies of PDE-5i medications in COPD-PH have shown conflicting results due to differing doses or durations of therapy and differing definitions of PH. In a prior study (ClinicalTrials.gov.identifier: NCT01862536), the investigators investigated the effects of up to 12 months of oral PDE-5i therapy with tadalafil on 6 minute walk distance (6MWD), a measure of exercise capacity in Veterans with COPD-PH, in a multi-center randomized placebo-controlled trial funded by the Department of Veterans Affairs. While tadalafil did not change 6MWD at 6 and 12 months (the primary outcome), the treatment group experienced changes in important secondary outcomes, with clinically meaningful improvement in patient-reported dyspnea and COPD-related health related quality of life after 6 months of therapy. Additionally, over 6 months, dyspnea worsened in the placebo group, and patients receiving PDE-5i therapy suffered fewer exacerbations. A limitation of this study was its small sample size. Given the importance of mitigating dyspnea among patients with COPD, the investigators will assess the effect of maximally tolerated therapy with tadalafil specifically on dyspnea powered as a primary outcome. In 126 participants with COPD-PH (63 treatment and 63 placebo) receiving usual clinical care for COPD, the investigators propose to evaluate effects of tadalafil on dyspnea among patients with COPD-PH in a prospective, double-blind, placebo-controlled clinical trial.
Aim 1: As primary outcome, the investigators will determine whether 6 months of daily oral tadalafil is more effective than placebo in reducing severity of patient-reported dyspnea, assessed by the University of California-San Diego Shortness of Breath Questionnaire (UCSD-SOBQ), in Veterans with COPD-PH. The investigators hypothesize that patients receiving tadalafil will report less dyspnea than those receiving placebo.
Aim 2: As a secondary outcome, the investigators will determine the effectiveness of tadalafil therapy on physical activity, assessed by objective daily step count, and functional capacity, assessed by 6MWD. The investigators hypothesize that patients on tadalafil therapy will have improved physical activity and functional capacity.
Aim 3: As a secondary outcome, the investigators will also assess the effects of tadalafil therapy on time to clinically important deterioration, a validated composite outcome defined as increase > 4U in the total health-related quality of life (St. George's Respiratory Questionnaire, SGRQ), decreased FEV1 of > 100ml, or moderate-severe acute exacerbations of COPD. The investigators hypothesize that Veterans with COPD-PH receiving tadalafil will be less likely to have clinically important deterioration.
Aim 4: In exploratory analyses, the investigators will assess whether changes in noninvasive measures of PH (CT scan, cardiac echo) are associated with changes in dyspnea. The investigators hypothesize that patients receiving tadalafil will have decreased PA/A ratio on CT scan, and decreased ePASP on echocardiography.
This study may provide evidence for a new therapy for dyspnea in COPD complicated by PH.
- Being tested
- Tadalafil, Placebo
- Keywords
- COPD, cigarette smoke, lung, echocardiography, chest CT, physical activity, spirometry, dyspnea, clinically important deterioration
- Medical subject headings
- Pulmonary Disease, Chronic Obstructive, Hypertension, Pulmonary, Dyspnea, Cigarette Smoking, Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TadalafilDrug
Also called Adcirca, Cialis
one or 2 encapsulated tablets of encapsulated tadalafil (20MG) po QD
PlaceboDrug
one or two encapsulated tablets of placebo po QD
| Study group | Role | What they receive |
|---|---|---|
| Placebo | Placebo comparator | Encapsulated placebo one or 2 encapsulated tablets po QD Receives: Drug: Placebo |
| tadalafil | Active comparator | one or 2 encapsulated tablets of encapsulated tadalafil (20MG) po QD Receives: Drug: Tadalafil |
What is being measured
The primary outcome is the main question the study is designed to answer.
severity of patient-reported dyspnea
Assessed by the University of California-San Diego Shortness of Breath Questionnaire (UCSD-SOBQ). Score range = 0-120 with higher scores indicating worse outcomes. Minimum score for inclusion in the study is 10.
Measured: 6 months
Secondary outcomes (3)
physical activity
assessed by objective average daily step count using actigraphy
Measured: 6 months
clinically important deterioration
Defined as the presence or absence of at least one of the following: increase > 4U in the total health-related quality of life (St. George's Respiratory Questionnaire, SGRQ), decreased FEV1 of > 100mL, or moderate-severe acute exacerbation of COPD
Measured: 6 months
functional exercise capacity
6 minute walk distance, defined as the distance walked in meters in 6 minutes
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Jul 2023
- Study start1 Apr 2024
- Primary completion1 Mar 2029 (estimated)
- Study completion1 Mar 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic Obstructive Pulmonary DiseaseStudies of the same condition, open and under way.
- More trials run by VA Office of Research and DevelopmentThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- double blind placebo-controlled
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 126 participants (estimated)
Sponsor and investigators
- Lead sponsor
- VA Office of Research and Development
- Sponsor type
- US federal agency
- Collaborators
- VA Boston Healthcare System, Atlanta VA Medical Center, VA Eastern Colorado Health Care System, VA Nebraska Western Iowa Health Care System
- Responsible party
- Sponsor
- Investigators
- Sharon I Rounds, MD, Principal investigator, Providence VA Medical Center, Providence, RI
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05937854
- Sponsor's protocol ID
- PULM-002-22F
- Other IDs
- I01CX002543
- Acronym
- BETTER COPD-PH
- Status last verified
- May 2026
- First submitted
- 27 Jun 2023
- Last updated
- 15 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: 1. Publications of results will be available to the public. 2. The principal investigator will share de-identified datasets, statistics, and results collected from this proposal by depositing these data at the National Library of Medicine (NLM) PubMed Central website repository as this is a VA supported data repository. Additional documentation including metadata that will include information about the methodology and study procedures used to collect the data, details about code, definition of variables will also be included.
Study at a glance
From the registry record, last updated by the sponsor on 15 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of PDE5 Inhibitor on Respiratory Symptoms in COPD Complicated by Pulmonary Hypertension
- ClinicalTrials.gov ID
- NCT05937854
- Acronym / sponsor ID
- BETTER COPD-PH / PULM-002-22F
- Keywords
- COPD, cigarette smoke, lung, echocardiography, chest CT, physical activity, spirometry, dyspnea
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 126 participants (estimated)
- Lead sponsor
- VA Office of Research and DevelopmentUS federal agency
- Collaborators
- VA Boston Healthcare System, Atlanta VA Medical Center, VA Eastern Colorado Health Care System, VA Nebraska Western Iowa Health Care System
- Study start
- 1 Apr 2024 (actual)
- Primary completion
- 1 Mar 2029 (estimated)
- Study completion
- 1 Mar 2029 (estimated)
- First posted
- 10 Jul 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators will study whether the drug tadalafil improves shortness of breath in 126 Veterans with Chronic Obstructive Pulmonary Disease (COPD) and high blood pressure in the lungs. The investigators will also assess whether tadalafil improves quality of life, home daily physical activity, exercise endurance, the frequency of acute flares of COPD, blood pressure in the lungs, and lung function. Veterans who enroll in the trial will be allocated by chance to either active tadalafil or an inactive identical capsule (placebo). Neither the Veteran nor the investigator will know whether the Veteran is taking tadalafil or placebo. Veterans will be followed closely in clinic or by telephone at 1, 2, 3, 4, 5, and 6 months, with attention to side effects and safety. At 1,3, and 6 months the investigators will repeat the questionnaires and testing of blood pressures in the lung and lung function. The investigators anticipate that the results of this study will determine whether tadalafil improves shortness of breath when added to usual medications for COPD.
Detailed description
Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the US and is common among Veterans. Dyspnea, a debilitating symptom of COPD, dramatically worsens health related quality of life, is associated with a reduction in daily physical activity and greater health care utilization and is more closely associated with survival than severity of airflow limitation. Thus, it is important to have effective treatments that reduce dyspnea for Veterans with COPD. Pulmonary hypertension (PH) is a common complication of COPD that is associated with severe dyspnea, more frequent acute exacerbations of COPD, and increased mortality. There are multiple causes of PH associated with COPD (COPD-PH), including decreased bioavailable levels of the vasodilator nitric oxide (NO). Phosphodiesterase type-5 inhibitor (PDE-5i) therapy restores NO signaling and improves cardiopulmonary hemodynamics and dyspnea among patients with Pulmonary Arterial Hypertension. However, studies of PDE-5i medications in COPD-PH have shown conflicting results due to differing doses or durations of therapy and differing definitions of PH. In a prior study (ClinicalTrials.gov.identifier: NCT01862536), the investigators investigated the effects of up to 12 months of oral PDE-5i therapy with tadalafil on 6 minute walk distance (6MWD), a measure of exercise capacity in Veterans with COPD-PH, in a multi-center randomized placebo-controlled trial funded by the Department of Veterans Affairs. While tadalafil did not change 6MWD at 6 and 12 months (the primary outcome), the treatment group experienced changes in important secondary outcomes, with clinically meaningful improvement in patient-reported dyspnea and COPD-related health related quality of life after 6 months of therapy. Additionally, over 6 months, dyspnea worsened in the placebo group, and patients receiving PDE-5i therapy suffered fewer exacerbations. A limitation of this study was its small sample size. Given the importance of mitigating dyspnea among patients with COPD, the investigators will assess the effect of maximally tolerated therapy with tadalafil specifically on dyspnea powered as a primary outcome. In 126 participants with COPD-PH (63 treatment and 63 placebo) receiving usual clinical care for COPD, the investigators propose to evaluate effects of tadalafil on dyspnea among patients with COPD-PH in a prospective, double-blind, placebo-controlled clinical trial.
Aim 1: As primary outcome, the investigators will determine whether 6 months of daily oral tadalafil is more effective than placebo in reducing severity of patient-reported dyspnea, assessed by the University of California-San Diego Shortness of Breath Questionnaire (UCSD-SOBQ), in Veterans with COPD-PH. The investigators hypothesize that patients receiving tadalafil will report less dyspnea than those receiving placebo.
Aim 2: As a secondary outcome, the investigators will determine the effectiveness of tadalafil therapy on physical activity, assessed by objective daily step count, and functional capacity, assessed by 6MWD. The investigators hypothesize that patients on tadalafil therapy will have improved physical activity and functional capacity.
Aim 3: As a secondary outcome, the investigators will also assess the effects of tadalafil therapy on time to clinically important deterioration, a validated composite outcome defined as increase > 4U in the total health-related quality of life (St. George's Respiratory Questionnaire, SGRQ), decreased FEV1 of > 100ml, or moderate-severe acute exacerbations of COPD. The investigators hypothesize that Veterans with COPD-PH receiving tadalafil will be less likely to have clinically important deterioration.
Aim 4: In exploratory analyses, the investigators will assess whether changes in noninvasive measures of PH (CT scan, cardiac echo) are associated with changes in dyspnea. The investigators hypothesize that patients receiving tadalafil will have decreased PA/A ratio on CT scan, and decreased ePASP on echocardiography.
This study may provide evidence for a new therapy for dyspnea in COPD complicated by PH.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- double blind placebo-controlled
| Arm | Type | Receives |
|---|---|---|
| Placebo | Placebo comparator | Drug: PlaceboEncapsulated placebo one or 2 encapsulated tablets po QD |
| tadalafil | Active comparator | Drug: Tadalafilone or 2 encapsulated tablets of encapsulated tadalafil (20MG) po QD |
Who may qualify
- Ages
- 35 to 89 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (16 listed)
- Outpatients with COPD, defined as airflow limitation with post-bronchodilator obstruction on baseline visit spirometry, identified by FEV1/FVC < 70% or < the lower limit of normal (5th percentile of a normal population based on Global Lung Function Initiative reference equations), OR any emphysema on chest CT noted in a clinical radiology report confirmed by study investigator review.
- Eligible subjects must have PH documented as follows:
- Eligible subjects must be dyspneic, as quantitated by a score of at least 20 on the baseline UCSD Shortness of Breath Questionnaire, assessed at the time of the baseline visit.
- Treatment with at least one long-acting bronchodilator for at least 4 weeks, assessed at the time of the baseline visit by chart review and patient interview.
- Age 35-89 Years
Key exclusion criteria (26 listed)
- Diagnosis of PH in the following subgroups of the updated WHO Clinical Classification:
- Systemic hypotension in the ambulatory setting (at least 3 reproducible measurements of systolic BP <89 mmHg, recorded by a health care provider over 1 week).
- Moderate or severe hepatic impairment (Child-Pugh B and C).
- Severe renal insufficiency (GFR <30 ml/min/1.73 m2)
- Echocardiography within 6 months showing greater than moderate aortic stenosis (aortic valve area <1.0 cm2), greater than moderate mitral regurgitation, or diastolic dysfunction (Any two of the following: Average E/e' >14, Septal e' velocity < 7 or lateral e' velocity <10, LA volume index > 34 ml/m2). LVEF < 50%. Any aortic or mitral valve replacement.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TadalafilAlso: Adcirca, Cialisone or 2 encapsulated tablets of encapsulated tadalafil (20MG) po QD | Drug | tadalafil |
| Placeboone or two encapsulated tablets of placebo po QD | Drug | Placebo |
Primary outcome
severity of patient-reported dyspnea
Time frame: 6 months
Assessed by the University of California-San Diego Shortness of Breath Questionnaire (UCSD-SOBQ). Score range = 0-120 with higher scores indicating worse outcomes. Minimum score for inclusion in the study is 10.
3 secondary outcomes
physical activity
Time frame: 6 months
clinically important deterioration
Time frame: 6 months
functional exercise capacity
Time frame: 6 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 May 2026.
- Individual participant dataSharing planned: Yes. 1. Publications of results will be available to the public. 2. The principal investigator will share de-identified datasets, statistics, and results collected from this proposal by depositing these data at the National Library of Medicine (NLM) PubMed Central website repository as this is a VA supported data repository. Additional documentation including metadata that will include information about the methodology and study procedures used to collect the data, details about code, definition of variables will also be included.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Sharon I Rounds, MD principal investigator
Providence VA Medical Center, Providence, RI
5 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Tadalafil in people with Chronic Obstructive Pulmonary Disease and Pulmonary Hypertension, run by VA Office of Research and Development at 5 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 16 inclusion and 26 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 15 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 5 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Sharon I Rounds, MD ((401) 273-7100, sharon.rounds@va.gov), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
severity of patient-reported dyspnea (time frame: 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 May 2026.