Clinical trial Phase 3 Interventional Ages 18 and up

A Study Evaluating the Long-Term Efficacy and Safety of Ralinepag in Subjects With PAH Via an Open-Label Extension

Run by United Therapeutics · NCT03683186 · Data updated 2026-11-12

Enrolling by invitation only. This study is not taking new participants. Its registered completion date is 2026-12.

Study ROR-PH-303, ADVANCE EXTENSION, is an open-label extension (OLE) study for participants with WHO Group 1 PAH who have participated in another Phase 2 or Phase 3 study of ralinepag.

Quick facts

PhasePhase 3
Study typeInterventional
Ages18 Years and up
SexAll
Enrollment1000 (estimated)
SponsorUnited Therapeutics
Industry-sponsored
Drugs / interventionsRalinepag
Locations190 sites (Argentina, Australia, Austria, Belgium, Brazil, Bulgaria, Canada, Chile and more)
Trial IDNCT03683186 on ClinicalTrials.gov

What this trial studies

Study ROR-PH-303 is a multicenter, open-label extension (OLE) study for subjects with WHO Group 1 PAH who have participated in another Phase 2 or Phase 3 study of ralinepag and who qualify for entry based upon participation in the prior study. Subjects who discontinue participation in a prior study due to safety issues related to study medication or who fail to complete study procedures will not be eligible to enter Study ROR-PH-303. Subjects who meet all OLE entry criteria will be enrolled and will receive ralinepag in addition to their pre-existing PAH disease-specific background therapy. For subjects who are enrolled from an ongoing double-blind Phase 2 or Phase 3 ralinepag study, a 16-week blinded Dose Titration Period will be completed following enrollment into the OLE. Subjects previously on ralinepag will continue on the same dose during the Dose Titration Period as received in the original study and will also initiate placebo treatment in the OLE. Subjects who are enrolled from a non-blinded study or another OLE will not participate in the blinded Dose Titration Period in Study ROR-PH-303 but will be enrolled directly into the Treatment Period and continue on the dose of ralinepag received in the original study. All subjects will receive ralinepag in the OLE study until premature discontinuation of ralinepag due to an AE/serious adverse event (SAE) or other reason, marketing approval of ralinepag is granted in the region in which the study is conducted, or the stud…

Who can join: the full rules

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. Evidence of a personally signed and dated informed consent form indicating that the subject has been informed of all pertinent aspects of the study prior to initiation of any study-related procedures.
2. Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
3. Completed the protocol-defined Study Drug Termination Visit or End of Study Visit procedures in the preceding ralinepag study.
4. Both male and female subjects agree to use a medically acceptable method of contraception throughout the entire study period from informed consent through the 30 day Follow-up Visit, if the possibility of conception exists. Eligible male and female subjects must also agree not to participate in a conception process (i.e., actively attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization) during the study and for 30 days after the last dose of ralinepag.

Exclusion Criteria:

1. Subjects who prematurely discontinued investigational medicinal product (IMP) due to a drug-related AE/SAE or tolerability issue in the preceding ralinepag study in which they were enrolled, or subjects who did not complete all protocol defined study procedures at a Study Drug Termination Visit or End of Study Visit in the preceding ralinepag study.
2. Subjects who withdrew consent during participation in another ralinepag study.
3. Female subjects who wish to become pregnant or who have a positive pregnancy test on Day 1 (OLE Entry Visit), or are lactating or breastfeeding.
4. Subjects who have undergone lung or heart/lung transplant or the initiation of long-term parenteral or inhaled therapy with a prostacyclin during the time since participation in their original ralinepag study.
5. Subjects who had an emergency unblinding procedure in a prior Phase 2 or 3 study.

Where it's running

  • St. Joseph's Hospital and Medical Center-Norton Thoracic Institute
    Phoenix, Arizona, United States
  • University of Arizona
    Tucson, Arizona, United States
  • UCSD Health Sciences
    La Jolla, California, United States
  • Ronald Reagan UCLA Medical Center
    Los Angeles, California, United States
  • Keck Hospital of USC
    Los Angeles, California, United States
  • VA Greater Los Angeles Healthcare System
    Los Angeles, California, United States
Show 44 more locations
  • University of California, Irvine
    Orange, California, United States
  • University of California Davis Medical Center
    Sacramento, California, United States
  • Santa Barbara Cottage Hospital
    Santa Barbara, California, United States
  • Stanford University Medical Center
    Stanford, California, United States
  • University of Colorado Hospital
    Aurora, Colorado, United States
  • National Jewish Health
    Denver, Colorado, United States
  • University of Florida
    Gainesville, Florida, United States
  • Central Florida Pulmonary Group
    Orlando, Florida, United States
  • Cleveland Clinic Florida
    Weston, Florida, United States
  • Emory University Hospital
    Atlanta, Georgia, United States
  • Piedmont Healthcare Pulmonary and Critical Care Research
    Austell, Georgia, United States
  • University of Chicago Medical Center
    Chicago, Illinois, United States
  • Ascension Alexian Brothers
    Elk Grove Village, Illinois, United States
  • Community Heart and Vascular Hospital
    Indianapolis, Indiana, United States
  • St. Vincent Medical Group, Inc.
    Indianapolis, Indiana, United States
  • University of Iowa Hospitals and Clinics
    Iowa City, Iowa, United States
  • University of Maryland Medical Center
    Baltimore, Maryland, United States
  • Tufts Medical Center
    Boston, Massachusetts, United States
  • Massachusetts General Hospital
    Boston, Massachusetts, United States
  • Boston University Medical Center
    Boston, Massachusetts, United States
  • Spectrum Health Medical Group
    Grand Rapids, Michigan, United States
  • Washington University School of Medicine
    St Louis, Missouri, United States
  • University of New Mexico
    Albuquerque, New Mexico, United States
  • NYU Langone Medical Center
    New York, New York, United States
  • University of Rochester
    Rochester, New York, United States
  • Duke University Medical Center
    Durham, North Carolina, United States
  • East Carolina University
    Greenville, North Carolina, United States
  • University of Cincinnati-Medical Science Building
    Cincinnati, Ohio, United States
  • The Ohio State University Wexner Medical Center
    Columbus, Ohio, United States
  • Integris Baptist Medical Center
    Oklahoma City, Oklahoma, United States
  • Oregon Health & Science University
    Portland, Oregon, United States
  • University of Pennsylvania
    Philadelphia, Pennsylvania, United States
  • Thomas Jefferson University Hospital
    Philadelphia, Pennsylvania, United States
  • Allegheny General Hospital
    Pittsburgh, Pennsylvania, United States
  • StatCare Pulmonary Consultants
    Knoxville, Tennessee, United States
  • Ascension Texas Cardiovascular
    Austin, Texas, United States
  • UT Southwestern Medical Center
    Dallas, Texas, United States
  • Memorial Hermann Hospital
    Houston, Texas, United States
  • The Methodist Hospital Research Institute
    Houston, Texas, United States
  • Vermont Lung Center
    Burlington, Vermont, United States
  • Carilion Clinic Pulmonary and Sleep Medicine
    Roanoke, Virginia, United States
  • Medical College of Wisconsin/Froedtert Hospital
    Milwaukee, Wisconsin, United States
  • Hospital Italiano
    Ciudad Autonoma de Buenos Aires, Buenos Aires, Argentina
  • Hospital PROVINCIAL "Dr. Jose Maria Cullen"
    Santa Fe, Santa Fe de La Vera Cruz, Argentina

+140 more sites. See ClinicalTrials.gov for the full list.

How to take part

  1. Review the eligibility criteria above with your treating physician.
  2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
  3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.
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Last reviewed 2026-11-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.