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Anti-Inflammatory Actions of Valsartan in Patients With Type 2 Diabetes Mellitus

Primary Purpose

Hypertension, Type 2 Diabetes Mellitus, Coronary Artery Disease

Status
Completed
Phase
Phase 4
Locations
Germany
Study Type
Interventional
Intervention
Valsartan
Placebo
Sponsored by
Charite University, Berlin, Germany
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypertension

Eligibility Criteria

30 Years - 80 Years (Adult, Older Adult)All Sexes

Inclusion Criteria:

  • Male or female patients between 30 and 80 years old, inclusive
  • Controlled type 2 Diabetes Mellitus on stable treatment at least during the 4 weeks prior to visit 1
  • Treated or untreated stage 1 (according to JNC VII Guidelines) or grade 1 (according to ESH/ESC 2003 Guidelines) hypertensive patients
  • For one stratum: angiographically proven CAD
  • Signed informed consent prior to any study procedure

Exclusion Criteria:

  • Hypertension classified as stage 2 (or grade 2) or higher
  • Normotensive patients, i.e. patients who do not have a history of high blood pressure, and who are not receiving any antihypertensive medication
  • Treatment with more than 2 antihypertensive medications
  • Current treatment with ARBs
  • Glycated hemoglobin (HbA1c) >8.5% at Visit 1
  • Current treatment with glitazones
  • Myocardial infarction less than 3 months prior to Visit 1
  • Total cholesterol >7.8 mmol/l
  • Past diagnosis of any systemic inflammatory disease
  • Known or suspected contraindications, including history of allergy to angiotensin receptor blockers
  • History of hypertensive encephalopathy or cerebrovascular accident less than 1 year prior to Visit 1
  • Known Keith-Wagener grade III or IV hypertensive retinopathy
  • History of heart failure
  • Second or third degree heart block without a pacemaker
  • Concomitant unstable angina pectoris
  • Concurrent potential life threatening arrhythmia or symptomatic arrhythmia
  • Clinically significant valvular heart disease
  • Evidence of hepatic disease as determined by any one of the following: ALT or AST values > 2 x ULN at Visit 1, a history hepatic encephalopathy, a history of esophageal varices, or a history of portocaval shunt
  • Evidence of renal impairment as determined by any one of the following: serum creatinine >1.25 x ULN at visit 1, a history of dialysis, or a history of nephritic syndrome
  • Sodium value <132 mmol/L at Visit 1
  • Serum potassium values <3.5 mmol/L or >5.5 mmol/L at visit 1
  • Any surgical or medical condition which might alter the absorption, distribution, metabolism, excretion of any drug
  • Female patients who are not either post-menopausal for one year of surgically sterile, and who are not using effective contraceptive methods such as barrier method with spermicidal or an intra-uterine device. Oral contraceptive use or dermal implants as the only means of contraception are disallowed
  • Pregnant or lactating females
  • Any surgical or medical condition which, at the discretion of the investigator, place the patient at higher risk from his/her participation in the study, or are likely to prevent the patients from complying with the requirements of the study or completing the trial period
  • History of malignancy including leukemia and lymphoma within 5 years prior to Visit 1
  • History of any severe, life threatening disease within the past five years
  • Any previous history of a systemic autoimmune disease
  • History of drug or alcohol abuse within the last two years
  • Participation in any investigational drug trial within one month prior to visit 1

Sites / Locations

  • University of Ulm, Department of Internal Medicine II
  • Charité University Medicine Berlin, Center for Cardiovascular Research, Outpatient Clinic

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Active Comparator

Arm Label

Placebo

Valsartan

Arm Description

Outcomes

Primary Outcome Measures

The primary objective of the study was to evaluate the anti-inflammatory effect of VAL by analyzing the reduction of the inflammatory markers interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα) in serum after 16 weeks of treatment.

Secondary Outcome Measures

To explore the effect of 160/320 mg valsartan on parameters of insulin sensitivity.
To explore the effect of 160/320 mg valsartan on additional inflammatory markers in plasma
To explore the effect of 160/320 mg valsartan on inflammatory gene expression from monocytes and fat tissue
To explore the effect of 160/320 mg valsartan on metabolic gene expression in fat tissue.
To explore the effect of 160/320 mg valsartan on coronary perfusion, in the group of patients with angiographically documented CAD

Full Information

First Posted
September 22, 2009
Last Updated
September 22, 2009
Sponsor
Charite University, Berlin, Germany
Collaborators
University of Ulm
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1. Study Identification

Unique Protocol Identification Number
NCT00982358
Brief Title
Anti-Inflammatory Actions of Valsartan in Patients With Type 2 Diabetes Mellitus
Official Title
A 16-weeks, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Anti-inflammatory Actions of 320 mg Diovan in Patients With Type 2 Diabetes With and Without Coronary Artery Disease
Study Type
Interventional

2. Study Status

Record Verification Date
September 2009
Overall Recruitment Status
Completed
Study Start Date
July 2004 (undefined)
Primary Completion Date
October 2006 (Actual)
Study Completion Date
March 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Charite University, Berlin, Germany
Collaborators
University of Ulm

4. Oversight

5. Study Description

Brief Summary
This study is designed to support the use of valsartan in the diabetic population. Two different groups will be studied, one with and one without coronary artery disease (CAD) documented by angiography. The study is intended to demonstrate that valsartan 320 mg has an anti-inflammatory potential, reducing inflammatory serum markers as well as inflammatory gene expression, and to show that valsartan is able to improve metabolic parameters in this patient population. Furthermore, in the subgroup of patients with documented CAD this study wants to show that valsartan improves coronary perfusion. 3 Objectives Primary objectives: To demonstrate the anti-inflammatory efficacy of valsartan 160/320 mg by testing the hypothesis of superiority compared to placebo in the reduction of the inflammatory marker Tumor necrosis factor alpha (TNFα) in plasma after 16 weeks of treatment in hypertensive patients with type 2 diabetes mellitus. To demonstrate the anti-inflammatory efficacy of valsartan 160/320 mg by testing the hypothesis of superiority compared to placebo in the reduction of the inflammatory marker Interleukin 6 (IL-6) in plasma after 16 weeks of treatment in hypertensive patients with type 2 diabetes mellitus. Secondary objectives: To explore the effect of 160/320 mg valsartan on parameters of insulin sensitivity. To explore the effect of 160/320 mg valsartan on additional inflammatory markers in plasma [e.g. C-Reactive protein (CRP), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), serum amyloid A (SAA), soluble CD40 ligand (sCD40L), fibrinogen, Interleukin 1β (IL-1β), matrix metalloproteases -2, -3 and -9 (MMP-2, -3, -9), and sE-selectin)]. To explore the effect of 160/320 mg valsartan on inflammatory gene expression from monocytes and fat tissue. To explore the effect of 160/320 mg valsartan on metabolic gene expression in fat tissue. To explore the effect of 160/320 mg valsartan on coronary perfusion, in the group of patients with angiographically documented CAD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertension, Type 2 Diabetes Mellitus, Coronary Artery Disease

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Title
Valsartan
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Valsartan
Intervention Type
Other
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
The primary objective of the study was to evaluate the anti-inflammatory effect of VAL by analyzing the reduction of the inflammatory markers interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα) in serum after 16 weeks of treatment.
Secondary Outcome Measure Information:
Title
To explore the effect of 160/320 mg valsartan on parameters of insulin sensitivity.
Title
To explore the effect of 160/320 mg valsartan on additional inflammatory markers in plasma
Title
To explore the effect of 160/320 mg valsartan on inflammatory gene expression from monocytes and fat tissue
Title
To explore the effect of 160/320 mg valsartan on metabolic gene expression in fat tissue.
Title
To explore the effect of 160/320 mg valsartan on coronary perfusion, in the group of patients with angiographically documented CAD

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
80 Years
Eligibility Criteria
Inclusion Criteria: Male or female patients between 30 and 80 years old, inclusive Controlled type 2 Diabetes Mellitus on stable treatment at least during the 4 weeks prior to visit 1 Treated or untreated stage 1 (according to JNC VII Guidelines) or grade 1 (according to ESH/ESC 2003 Guidelines) hypertensive patients For one stratum: angiographically proven CAD Signed informed consent prior to any study procedure Exclusion Criteria: Hypertension classified as stage 2 (or grade 2) or higher Normotensive patients, i.e. patients who do not have a history of high blood pressure, and who are not receiving any antihypertensive medication Treatment with more than 2 antihypertensive medications Current treatment with ARBs Glycated hemoglobin (HbA1c) >8.5% at Visit 1 Current treatment with glitazones Myocardial infarction less than 3 months prior to Visit 1 Total cholesterol >7.8 mmol/l Past diagnosis of any systemic inflammatory disease Known or suspected contraindications, including history of allergy to angiotensin receptor blockers History of hypertensive encephalopathy or cerebrovascular accident less than 1 year prior to Visit 1 Known Keith-Wagener grade III or IV hypertensive retinopathy History of heart failure Second or third degree heart block without a pacemaker Concomitant unstable angina pectoris Concurrent potential life threatening arrhythmia or symptomatic arrhythmia Clinically significant valvular heart disease Evidence of hepatic disease as determined by any one of the following: ALT or AST values > 2 x ULN at Visit 1, a history hepatic encephalopathy, a history of esophageal varices, or a history of portocaval shunt Evidence of renal impairment as determined by any one of the following: serum creatinine >1.25 x ULN at visit 1, a history of dialysis, or a history of nephritic syndrome Sodium value <132 mmol/L at Visit 1 Serum potassium values <3.5 mmol/L or >5.5 mmol/L at visit 1 Any surgical or medical condition which might alter the absorption, distribution, metabolism, excretion of any drug Female patients who are not either post-menopausal for one year of surgically sterile, and who are not using effective contraceptive methods such as barrier method with spermicidal or an intra-uterine device. Oral contraceptive use or dermal implants as the only means of contraception are disallowed Pregnant or lactating females Any surgical or medical condition which, at the discretion of the investigator, place the patient at higher risk from his/her participation in the study, or are likely to prevent the patients from complying with the requirements of the study or completing the trial period History of malignancy including leukemia and lymphoma within 5 years prior to Visit 1 History of any severe, life threatening disease within the past five years Any previous history of a systemic autoimmune disease History of drug or alcohol abuse within the last two years Participation in any investigational drug trial within one month prior to visit 1
Facility Information:
Facility Name
University of Ulm, Department of Internal Medicine II
City
Ulm
State/Province
Baden-Wuerttemberg
ZIP/Postal Code
89081
Country
Germany
Facility Name
Charité University Medicine Berlin, Center for Cardiovascular Research, Outpatient Clinic
City
Berlin
ZIP/Postal Code
10115
Country
Germany

12. IPD Sharing Statement

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Anti-Inflammatory Actions of Valsartan in Patients With Type 2 Diabetes Mellitus

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