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SAFE-CRP: Structural Alterations and Function of Endothelium in Cardiovascular Risk Patients

Primary Purpose

Hypertension, Coronary Arteriosclerosis

Status
Terminated
Phase
Phase 4
Locations
Germany
Study Type
Interventional
Intervention
telmisartan
Placebo
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypertension

Eligibility Criteria

36 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria: > 35 years of age History of coronary artery disease (CAD) Ability to provide written informed consent Exclusion criteria: Pre-menopausal women (last menstruation < 1 year prior to start of the screening visit) who: are not surgically sterile; and/or are nursing are of child-bearing potential and are NOT practising acceptable means of birth control, do NOT plan to continue using this method throughout the study and do NOT agree to submit to periodic pregnancy testing during participation in studies of > 3-months duration. Acceptable methods of birth control include oral, implantable or injectable contraceptives Diastolic blood pressure > 110 mmHg or systolic blood pressure > 180 mmHg at any visit during the study (run-in or randomised period) Hepatic and/or renal dysfunction as defined by the following laboratory parameters: SGPT(ALT) or SGOT(AST) > than 2 times the upper limit of normal range Serum creatinine > 2.3 mg/dL Bilateral renal artery stenosis, renal artery stenosis in a solitary kidney, patients post-renal transplant or with only one kidney Clinically relevant hypokalaemia or hyperkalaemia Uncorrected volume depletion Uncorrected sodium depletion Primary aldosteronism Hereditary fructose intolerance Biliary obstructive disorders Patients who have previously experienced symptoms characteristic of angioedema during treatment with ACE inhibitors or angiotensin II receptor antagonists History of drug or alcohol dependency within 6 months Chronic administration of any medications known to affect blood pressure, except medication allowed by the protocol Any investigational therapy within one month of signing the informed consent form Known hypersensitivity to any component of the formulation Any other clinical condition which, in the opinion of the principal investigator, would not allow safe completion of the protocol and safe administration of telmisartan Stroke within the last 6 months Myocardial infarction within the last 30 days Cardiac surgery within the last 3 months Hyperthyroidosis Hemodynamically relevant valvular disease Restrictive hypertrophic cardiomyopathy Unstable angina pectoris CAD with the indication of bypass surgery.

Sites / Locations

  • Universitätsklinikum Charité
  • Med. Hochschule Hannover

Outcomes

Primary Outcome Measures

Change of intima/media ratio in the femoral artery measured by intravascular ultrasound (IVUS)

Secondary Outcome Measures

Change in plaque size in the femoral artery measured by IVUS
Increase in FDD (Flow dependent dilation) stimulated by intra-arterial infusion of Acetylcholine (ACH)
Change in serum inflammatory markers (CRP, MCP-1, oxLDL antibodies, and VCAM)
Change in seated blood pressure (BP) at trough

Full Information

First Posted
January 9, 2006
Last Updated
October 31, 2013
Sponsor
Boehringer Ingelheim
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1. Study Identification

Unique Protocol Identification Number
NCT00274105
Brief Title
SAFE-CRP: Structural Alterations and Function of Endothelium in Cardiovascular Risk Patients
Official Title
A Double Blind, 2:1 Randomised Monocentre Study to Investigate the Efficacy and Safety of Telmisartan (80 mg qd) Concerning the Amelioration of Structural Alterations and Function of Endothelium in Cardiovascular Risk Patients (SAFE-CRP: Structural Alterations and Function of Endothelium in Cardiovascular Risk Patients)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2013
Overall Recruitment Status
Terminated
Study Start Date
March 2001 (undefined)
Primary Completion Date
October 2004 (Actual)
Study Completion Date
October 2004 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Boehringer Ingelheim

4. Oversight

5. Study Description

Brief Summary
The aim of this trial is to evaluate the efficacy and safety of telmisartan 80 mg administered once daily in patients with documented coronary artery disease (CAD) and a probably cardiovascular risk profile concerning the amelioration of structural alterations and endothelial function. The primary objective of this trial is to evaluate the efficacy in particular with regard to the percentage change of atheroma volume in the femoral artery.The secondary objective is to evaluate the change in the plaque size- assessed by intravascular ultrasound, the increase in Flow Dependent Dilation provoked by intraarterial infusion of three increasing concentrations of Acetylcholine, and the change in seated systolic blood pressure. Endothelial dysfunction is a primary event in atherogenesis and all known cardiovascular risk factors have been associated with endothelial dysfunction before atherosclerotic vascular disease manifests itself clinically. Pivotal to endothelial dysfunction is a disturbance in the function of endothelium-derived nitric oxide (NO). Recently, it could be shown that acute and chronic angiotensin-1 receptor antagonism reversed endothelial dysfunction in atherosclerosis. In experimental atherosclerosis, AT1 receptor blockade appears to have protective effects. Respective potential mechanisms include the prevention of endothelial injury, the augmentation of NO activity, the inhibition of lipid peroxidation and an antiproliferative effect. These findings together with the most recent data that losartan improves endothelial function and NO activity suggest that AT1 receptor antagonism may also be antiatherogenic in patients with atherosclerosis. Angiotensin II influences smooth muscle cell migration, hyperplasia, and hypertrophy. Angiotensin II also enhances production of local superoxide anion, which will inactivate nitric oxide. Inhibition of these reactions by the AT1-Blocker telmisartan may therefore interfere with atherosclerotic plaque formation.
Detailed Description
Methodology: 2:1 randomised, double-blind and placebo-controlled parallel-group design Planned/actual number of subjects: Enrolled: 30/33, randomised: 30/22, completed: 30/15 Duration of treatment: 9 months: telmisartan (80 mg) or Placebo (80 mg) Study Hypothesis: The trial is designed as a group comparison of telmisartan 80 mg and placebo, where the treatment groups are randomised in 2:1 relation, to investigate the efficacy of telmisartan on structural alterations and endothelial dysfunction as measured as the percentage change from baseline after 36 weeks of treatment of the atheroma volume in the femoral artery using IVUS . Secondary endpoints are the changes from baseline in the flow dependent dilatation after a acetylcholine challenge which follows a nitro-glycerin bolus, the change of the total atheroma volume, the percentage atheroma volume measured by intravascular ultrasound (IVUS) and the infalmmatory parameters MCP-1, CRP, ox LDL antibodies and sPLA2 activity and amount. In an analysis of covariance using baseline as covariate all endpoints will be investigated. If the assumptions of normal distribution are not fulfilled, nonparametric methods will be applied (Wilcoxon-Mann-Whitney test). Comparison(s): Placebo 80 mg

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertension, Coronary Arteriosclerosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
Double
Allocation
Randomized
Enrollment
22 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
telmisartan
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Change of intima/media ratio in the femoral artery measured by intravascular ultrasound (IVUS)
Time Frame
after 39 weeks
Secondary Outcome Measure Information:
Title
Change in plaque size in the femoral artery measured by IVUS
Time Frame
after 39 weeks
Title
Increase in FDD (Flow dependent dilation) stimulated by intra-arterial infusion of Acetylcholine (ACH)
Time Frame
after 39 weeks
Title
Change in serum inflammatory markers (CRP, MCP-1, oxLDL antibodies, and VCAM)
Time Frame
after 39 weeks
Title
Change in seated blood pressure (BP) at trough
Time Frame
after 39 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
36 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: > 35 years of age History of coronary artery disease (CAD) Ability to provide written informed consent Exclusion criteria: Pre-menopausal women (last menstruation < 1 year prior to start of the screening visit) who: are not surgically sterile; and/or are nursing are of child-bearing potential and are NOT practising acceptable means of birth control, do NOT plan to continue using this method throughout the study and do NOT agree to submit to periodic pregnancy testing during participation in studies of > 3-months duration. Acceptable methods of birth control include oral, implantable or injectable contraceptives Diastolic blood pressure > 110 mmHg or systolic blood pressure > 180 mmHg at any visit during the study (run-in or randomised period) Hepatic and/or renal dysfunction as defined by the following laboratory parameters: SGPT(ALT) or SGOT(AST) > than 2 times the upper limit of normal range Serum creatinine > 2.3 mg/dL Bilateral renal artery stenosis, renal artery stenosis in a solitary kidney, patients post-renal transplant or with only one kidney Clinically relevant hypokalaemia or hyperkalaemia Uncorrected volume depletion Uncorrected sodium depletion Primary aldosteronism Hereditary fructose intolerance Biliary obstructive disorders Patients who have previously experienced symptoms characteristic of angioedema during treatment with ACE inhibitors or angiotensin II receptor antagonists History of drug or alcohol dependency within 6 months Chronic administration of any medications known to affect blood pressure, except medication allowed by the protocol Any investigational therapy within one month of signing the informed consent form Known hypersensitivity to any component of the formulation Any other clinical condition which, in the opinion of the principal investigator, would not allow safe completion of the protocol and safe administration of telmisartan Stroke within the last 6 months Myocardial infarction within the last 30 days Cardiac surgery within the last 3 months Hyperthyroidosis Hemodynamically relevant valvular disease Restrictive hypertrophic cardiomyopathy Unstable angina pectoris CAD with the indication of bypass surgery.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Boehringer Ingelheim Study Coordinator
Organizational Affiliation
B.I. Pharma GmbH & Co. KG
Official's Role
Study Chair
Facility Information:
Facility Name
Universitätsklinikum Charité
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Med. Hochschule Hannover
City
Hannover
ZIP/Postal Code
30623
Country
Germany

12. IPD Sharing Statement

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SAFE-CRP: Structural Alterations and Function of Endothelium in Cardiovascular Risk Patients

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