Sildenafil Versus Placebo for Early Pulmonary Vascular Disease in Scleroderma (SEPVADIS): protocol for a randomized controlled trial

Matthew R. Lammi, Monica Mukherjee, Lesley Ann Saketkoo, Kyle Carey, Laura Hummers, Steven Hsu, Amita Krishnan, Marie Sandi, Ami A. Shah, Stefan L. Zimmerman, Paul M. Hassoun, Steven C. Mathai

Research output: Contribution to journalArticlepeer-review


Background: Pulmonary hypertension (PH) is a leading cause of death in patients with systemic sclerosis (SSc). An important component of SSc patient management is early detection and treatment of PH. Recently the threshold for the diagnosis of PH has been lowered to a mean pulmonary artery pressure (mPAP) threshold of > 20 mmHg on right heart catheterization (RHC). However, it is unknown if PH-specific therapy is beneficial in SSc patients with mildly elevated pressure (SSc-MEP, mPAP 21–24 mmHg). Methods: The SEPVADIS trial is a randomized, double-blind, placebo-controlled phase 2 trial of sildenafil in SSc-MEP patients with a target enrollment of 30 patients from two academic sites in the United States. The primary outcome is change in six-minute walk distance after 16 weeks of treatment. Secondary endpoints include change in pulmonary arterial compliance by RHC and right ventricular function by cardiac magnetic resonance imaging at 16 weeks. Echocardiography, serum N-terminal probrain natriuretic peptide, and health-related quality of life is being measured at 16 and 52 weeks. Discussion: The SEPVADIS trial will be the first randomized study of sildenafil in SSc-MEP patients. The results of this trial will be used to inform a phase 3 study to investigate the efficacy of treating patients with mild elevations in mPAP. Trial registration: Identifier NCT04797286.

Original languageEnglish (US)
Article number211
JournalBMC pulmonary medicine
Issue number1
StatePublished - Dec 2024


  • Clinical trial
  • Pulmonary hypertension
  • Scleroderma
  • Sildenafil
  • Systemic sclerosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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