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COPD (Chronic Obstructive Pulmonary Disease)Phase 2TyvasoNCT07037836

Inhaled Treprostinil (Tyvaso Nebulizer) For COPD Patients With Hypoxemia

A Phase 2 study testing Inhaled Treprostinil (Tyvaso Nebulizer) in people with COPD (Chronic Obstructive Pulmonary Disease) and Hypoxemia, run by Bastiaan Driehuys at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to evaluate whether inhaled Treprostinil (Tyvaso) can improve oxygen delivery and blood flow in the lungs in adults (age ≥40) with chronic obstructive pulmonary disease (COPD) and hypoxemia who have less severe reduction in lung blood volume (diffusing capacity of the lungs for… Read more about this study

Who is it for?
Ages 40 years and older
What is being tested?
Inhaled Treprostinil (Tyvaso Nebulizer)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteUnited States
Study dates
29 Sep 2025to 1 Jul 2027
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 40 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Outpatients of either gender, age ≥ 40.
  • Clinical evidence of chronic bronchitis (a productive cough lasting more than 3 months within a 2-year period).
  • Current or former cigarette smokers with a smoking history of 20 or more pack-years.
  • Clinical diagnosis of chronic obstructive pulmonary disease (COPD) confirmed by spirometry demonstrating forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio < 0.70, pre-bronchodilator FEV1 ≥ 30% predicted, and diffusing capacity of the lungs for carbon monoxide (DLCO) ≥ 45% predicted.
  • On stable maintenance COPD medications including inhaled corticosteroids (ICS), long-acting beta agonists (LABA), long-acting muscarinic antagonists (LAMA), combination inhalers, azithromycin, or roflumilast (with no changes over the past 3 months).
  • Patients with hypoxemia, evidenced by the use of supplemental oxygen at rest or during exercise (≤ 4 liters/minute).
  • Willing and able to give informed consent and adhere to visit and protocol schedules (consent must be obtained prior to any study procedures).
  • Women of childbearing potential must have a negative serum pregnancy test, confirmed prior to participation in this investigational protocol.

Who cannot join

  • Upper respiratory tract infection within 6 weeks (participants may be rescreened after this period).
  • History of lung resection surgery or pleural decortication.
  • Previous history of pneumothorax.
  • Imaging evidence of interstitial lung disease, occupational lung disease, or chronic infectious lung disease.
  • History of asthma.
  • History of exposure to occupational or environmental hazards known to cause lung disease.
Show all 16Show fewer
  • Positive pregnancy test for women of childbearing potential.
  • Major chronic illness that, in the judgment of the study physician, would interfere with participation in the study.
  • For Magnetic Resonance Imaging (MRI):
  • Contraindications to MRI based on screening questionnaire responses.
  • Participant is pregnant or lactating.
  • Respiratory illness of bacterial or viral etiology within 6 weeks prior to MRI.
  • Known cardiac arrhythmia.
  • Participant does not fit into the hyperpolarized xenon-129 (^129Xe) vest coil used for MRI.
  • Participant cannot hold their breath for 10 seconds.
  • Participant is unlikely to comply with instructions during imaging.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Yuh-Chin Huang, M.D., M.H.S., MD contact

919-684-3069

yuhchin.huang@duke.edu

United States1 site, 1 recruiting
  • Duke Asthma Allergy and Airway Center

    Durham, North Carolina, 27705

    Savannah Barbieri, 919613740, savannah.barbieri@duke.edu

    Jessica Shier, jessica.shier@duke.edu

    Recruiting

Other trials in United States

About this study

The goal of this clinical trial is to evaluate whether inhaled Treprostinil (Tyvaso) can improve oxygen delivery and blood flow in the lungs in adults (age ≥40) with chronic obstructive pulmonary disease (COPD) and hypoxemia who have less severe reduction in lung blood volume (diffusing capacity of the lungs for carbon monoxide [DLCO] ≥45%).

The main questions it aims to answer are:

Read more
  1. Does inhaled Treprostinil increase pulmonary capillary blood volume in ventilated lung regions, as measured by hyperpolarized xenon-129 magnetic resonance imaging (HP129Xe MRI)?
  2. Does inhaled Treprostinil improve oxygen delivery (measured as red blood cell [RBC] chemical shift) and maintain or only slightly change pulmonary vascular resistance (measured by RBC oscillation amplitude)?
  3. Can pre-treatment MRI parameters (RBC transfer and RBC oscillation amplitude) predict who will respond to inhaled Treprostinil?

Participants will:

  • Use the Tyvaso nebulizer (inhaled Treprostinil) 4 times daily for 4 weeks, starting at 3 breaths per session and increasing to a maximum of 6 breaths per session as tolerated.
  • Undergo HP129Xe MRI before and after treatment to assess regional lung function and oxygen exchange.
  • Complete pulmonary function tests (PFTs), 6-minute walk tests (6MWT), and echocardiograms at the beginning and end of the study.
  • Be monitored for adverse events, with a phone check-in midway through and after the treatment period.
Read the detailed description

This is a single-arm, proof-of-concept study evaluating the effects of inhaled Treprostinil (Tyvaso nebulizer) on regional gas exchange and capillary blood oxygenation in patients with chronic obstructive pulmonary disease (COPD) and hypoxemia. The study will enroll 10 outpatient subjects aged ≥40 with a chronic bronchitis phenotype, confirmed COPD diagnosis, and a diffusing capacity of the lungs for carbon monoxide (DLCO) ≥45% predicted. All participants will receive inhaled Treprostinil via a 4-week dose titration protocol (starting at 3 breaths four times daily and increasing to 6 breaths as tolerated).

The primary objectives are to "determine the effects of inhaled Treprostinil on regional gas exchange and capillary blood oxygenation as measured by hyperpolarized xenon-129 magnetic resonance imaging (HP129Xe MRI), including ventilation defect percentage (VDP), membrane defect percentage, red blood cell (RBC) transfer defect percentage and normalized RBC oscillation amplitude and RBC frequency shift," and to "determine whether pre-treatment VDP, membrane defect percentage, RBC transfer defect percentage, RBC chemical shift and normalized RBC oscillation amplitude predict a positive response to inhaled Treprostinil."

Assessments will include HP129Xe MRI, spirometry with DLCO, 6-minute walk testing (6MWT), and echocardiography at baseline and after 4 weeks. Data will be analyzed for changes in regional lung function and oxygenation. Safety monitoring will focus on known adverse effects of inhaled Treprostinil including "cough, headache, hypotension, oropharyngeal pain, throat irritation and nausea," and will address more serious risks observed in the PERFECT trial (COPD exacerbation, respiratory failure, myocardial infarction, and death). By selecting subjects with DLCO ≥45% predicted and using a shorter 4-week treatment duration with titrated dosing, the study aims to mitigate these risks.

Being tested
Inhaled Treprostinil (Tyvaso Nebulizer)
Keywords
Tyvaso, COPD, Hypoxemia
Medical subject headings
Pulmonary Disease, Chronic Obstructive, Hypoxia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Inhaled Treprostinil (Tyvaso Nebulizer)Drug

    Participants will receive inhaled Treprostinil (Tyvaso nebulizer), 6 µg per breath, administered four times daily for 4 weeks. The starting dose will be 3 breaths per session. The dose will increase by 1 breath per session each week, as tolerated, to a target of 6 breaths per session by week 4. If adverse effects occur, participants will remain at the highest tolerated dose. The drug will be administered using the Tyvaso inhalation system provided by United Therapeutics. No changes to baseline COPD maintenance medications are allowed during the treatment period. Participants will be monitored for safety throughout the study.

Study groups in NCT07037836
Study groupRoleWhat they receive
Inhaled Treprostinil in COPD Patients With Hypoxemia and Preserved DLCOExperimentalNot described
Receives: Drug: Inhaled Treprostinil (Tyvaso Nebulizer)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Ventilation Defect Percentage (VDP) on HP129XeMRI

    Defined as the region with ventilation signals < mean - 2SD, measured by HP129XeMRI and expressed as a percentage of total lung volume.

    Measured: Baseline and 4 weeks post-Tyvaso

  2. Membrane Defect Percentage on HP129XeMRI

    Defined as the region with membrane signals < mean - 2SD, measured by HP129XeMRI and expressed as a percentage of total lung volume.

    Measured: Baseline and 4 weeks post-Tyvaso

  3. Low Membrane Region Percentage on HP129XeMRI

    Defined as the region with membrane signals between 1SD and 2SD below the mean, measured by HP129XeMRI and expressed as a percentage of total lung volume.

    Measured: Baseline and 4 weeks post-Tyvaso

  4. RBC Transfer Defect Percentage on HP129XeMRI

    Defined as the region with RBC transfer signals < mean - 2SD, measured by HP129XeMRI and expressed as a percentage of total lung volume.

    Measured: Baseline and 4 weeks post-Tyvaso

  5. Low RBC Transfer Region Percentage on HP129XeMRI

    Defined as the region with RBC transfer signals between 1SD and 2SD below the mean, measured by HP129XeMRI and expressed as a percentage of total lung volume.

    Measured: Baseline and 4 weeks post-Tyvaso

  6. RBC Oscillation Amplitude Normalized for RBC Transfer Defect

    Measured using HP129XeMRI spectroscopy as a surrogate for pulmonary vascular resistance, normalized to RBC transfer signal intensity.

    Measured: Baseline and 4 weeks post-Tyvaso

  7. RBC Chemical Shift on HP129XeMRI Spectroscopy

    Frequency shift in RBC signal reflecting capillary blood oxygenation, measured using HP129XeMRI spectroscopy.

    Measured: Baseline and 4 weeks post-Tyvaso

Secondary outcomes (11)
  1. Nadir SpO₂ During 6MWT

    Lowest oxygen saturation (SpO₂) recorded during the 6-minute walk test, measured by pulse oximetry. The test is performed on room air unless SpO₂ drops below 89%, at which point supplemental oxygen is administered to maintain SpO₂ ≥89%.

    Measured: Baseline and 4 weeks post-Tyvaso treatment

  2. Supplemental Oxygen Flow During 6MWT

    Oxygen flow rate in liters per minute required to maintain SpO₂ ≥89% during the 6-minute walk test if room air is insufficient.

    Measured: Baseline and 4 weeks post-Tyvaso treatment

  3. 6-Minute Walk Distance (6MWD)

    Total distance walked in meters during the 6-minute walk test, following ATS guidelines.

    Measured: Baseline and 4 weeks post-Tyvaso treatment

  4. Dyspnea Score During 6MWT

    Subjective rating of dyspnea severity on a 1-10 scale reported by participants at the end of the 6-minute walk test.

    Measured: Baseline and 4 weeks post-Tyvaso treatment

  5. Peak Heart Rate (% Predicted) During 6MWT

    Highest heart rate achieved during the 6-minute walk test, expressed as a percentage of predicted maximum heart rate.

    Measured: Baseline and 4 weeks post-Tyvaso treatment

  6. Forced Expiratory Volume in 1 Second (FEV1) - Absolute and % Predicted

    EV1 measured in liters and as a percentage of predicted value, assessed by spirometry.

    Measured: Baseline and 4 weeks post-Tyvaso treatment

  7. Forced Vital Capacity (FVC) - Absolute and % Predicted

    FVC measured in liters and as a percentage of predicted value, assessed by spirometry

    Measured: Baseline and 4 weeks post-Tyvaso treatment

  8. Total Lung Capacity (TLC) - Absolute and % Predicted

    TLC measured in liters and as a percentage of predicted value, assessed by lung volume testing.

    Measured: Baseline and 4 weeks post-Tyvaso treatment

  9. Residual Volume (RV) - Absolute and % Predicted

    RV measured in liters and as a percentage of predicted value, assessed by lung volume testing.

    Measured: Baseline and 4 weeks post-Tyvaso treatment

  10. Diffusing Capacity for Carbon Monoxide (DLCO) - Absolute and % Predicted

    DLCO measured in mL/min/mmHg and as a percentage of predicted value, assessed by single-breath method.

    Measured: Baseline and 4 weeks post-Tyvaso treatment

  11. Carbon Monoxide Transfer Coefficient (KCO) - Absolute and % Predicted

    KCO measured in mL CO/min/mmHg/L and as a percentage of predicted value, derived from DLCO and alveolar volume.

    Measured: Baseline and 4 weeks post-Tyvaso treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jun 2025
  2. Study start29 Sep 2025
  3. Primary completion1 Jul 2027 (estimated)
  4. Study completion1 Jul 2027 (estimated)

Resources

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
10 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07037836
Sponsor's protocol ID
PRO00118083
Acronym
Tyvaso
Status last verified
Aug 2026
First submitted
9 May 2025
Last updated
27 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: Individual participant data (IPD) will not be shared for this study. The consent form limits future data use to internal research on lung disease and COPD and does not authorize sharing of de-identified IPD with external investigators. Therefore, data cannot be made available to other researchers outside of the study team.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Inhaled Treprostinil (Tyvaso Nebulizer) in people with COPD (Chronic Obstructive Pulmonary Disease) and Hypoxemia, run by Bastiaan Driehuys at 1 site 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 8 inclusion and 16 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 27 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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. 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 Yuh-Chin Huang, M.D., M.H.S., MD (919-684-3069, yuhchin.huang@duke.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Ventilation Defect Percentage (VDP) on HP129XeMRI (time frame: Baseline and 4 weeks post-Tyvaso). The study lists 7 primary outcomes in all. 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 27 Aug 2026.

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