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The Impact of Nebivolol Versus Metoprolol on Quality of Life

Primary Purpose

Transplant; Failure, Kidney, Hypertension

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Nebivolol
Metoprolol succinate
Sponsored by
Brigham and Women's Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Transplant; Failure, Kidney focused on measuring kidney, transplant, hypertension, nebivolol, metoprolol, bystolic, toprol

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adult renal transplant recipients, men and women between 18 and 75 years of age, inclusive.
  • Patients must be > 3 months post-transplant.
  • Patients must have stable renal function (stable renal function will be defined as those patients without infection or hospitalization [for any reason] over the past 30 days, and patients with < 20% change in their serum creatinine over the past 30 days.
  • Patients receiving corticosteroids must be receiving a daily dose of < 7.5 mg of prednisone (or therapeutic equivalents based on glucocorticoid equivalency scale).
  • All eligible patients must be receiving antihypertensive medication management which must include metoprolol tartrate or metoprolol succinate.
  • Patients may be on more than one medication to control their hypertension. Use of any other FDA-approved antihypertensive agent is permitted.
  • All eligible patients will either be at goal blood pressure (<120/80 mmHg) or have Pre-hypertension (<140/90 mmHg) or Stage I hypertension (<160/100 mmHg) at the time of study inclusion.
  • Patients who are able to comprehend and satisfactorily comply with protocol requirements.
  • Patients who signed the written informed consent given prior to entering any study procedure.

Exclusion Criteria:

  • Patients with Stage II/uncontrolled hypertension (>159/99 mmHg).
  • Patients with an easily identifiable etiology for fatigue (i.e. anemia, iron-deficiency, poor sleep patterns, etc.).
  • Patients who have a medical condition that, in the Investigator's opinion, would expose them to an increased risk of a significant adverse event or interfere with assessments of safety and efficacy during the course of the trial (i.e. arrhythmia).
  • Patients with any current malignancy, or any clinically significant hematological, endocrine, cardiovascular, hepatic, gastrointestinal or neurological disease (including any form of epilepsy). If there is a history of such disease but the condition has been stable for at least the past year and is judged by the investigator not to interfere with the patient's participation in the study, the patient may be included.
  • Patients who are judged by the investigator to be unable or unlikely to follow the study protocol and complete all scheduled visits.
  • Patients with any contraindications to beta blocker therapy as listed in the package labeling for both metoprolol succinate and nebivolol.

Sites / Locations

  • Brigham and Women's Hospital
  • Lahey Clinic

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Nebivolol

Metoprolol Succinate

Arm Description

Outcomes

Primary Outcome Measures

Quality of Life
Primary outcome measure will be the change from the Screening/Enrollment Visit to the End of the Study/Early Termination visit in scores of four quality of life questionnaires. The four quality of life questionnaires that were used included the following: Short Form (SF)-36v2 Health Survey (Score Range = 0-100; the lower the score the more disability) Sexual Dysfunction Tool for Men = International Index of Erectile Function (IIEF) Questionnaire (Score Range = 5-25; a score of 22-25 = No erectile dysfunction; 17-21 = Mild erectile dysfunction; 12-16 = Mild to moderate erectile dysfunction; 8-11 = Moderate erectile dysfunction; 5-7 = Severe erectile dysfunction) Sexual Dysfunction Tool for Women = Changes in Sexual Functioning Questionnaire (CSFQ-14-F; Score Range = 14-70; a score at or below 42 is indicative of sexual dysfunction) Multidimensional Assessment of Fatigue (MAF) Scale (Score Range = 1-50; the higher the score the more fatigue)

Secondary Outcome Measures

Blood Pressure
Evaluate the baseline and follow-up systolic and diastolic blood pressures for all subjects in both groups.

Full Information

First Posted
September 26, 2011
Last Updated
March 9, 2017
Sponsor
Brigham and Women's Hospital
Collaborators
Forest Laboratories, Lahey Clinic
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1. Study Identification

Unique Protocol Identification Number
NCT01441570
Brief Title
The Impact of Nebivolol Versus Metoprolol on Quality of Life
Official Title
The Impact of Nebivolol Versus Metoprolol on Quality of Life Measures and Cost-effectiveness in Stable Renal Transplant Recipients
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Terminated
Why Stopped
due to slow enrollment
Study Start Date
February 2012 (undefined)
Primary Completion Date
July 2013 (Actual)
Study Completion Date
July 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Brigham and Women's Hospital
Collaborators
Forest Laboratories, Lahey Clinic

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
In an open label analysis, nebivolol has been shown to have a positive impact on quality of life in the general hypertensive population. That is, patients treated with nebivolol reported less side effects compared to those treated with metoprolol. Also, more nebivolol treated patients reached normalization of blood pressure. Although there is no data, it is believed that the impact would be similar in renal transplant recipients. The primary goal of this study is to determine if nebivolol will improve the quality of life measurements of kidney transplant recipients as compared to those treated with metoprolol succinate. This will be measured by comparing the scores of four quality of life questionnaires taken before and after 12 weeks of treatment with study drug. Other aims of this study are to determine if the use of nebivolol is cost-effective in the renal transplant recipient; determine if there is a change in urine protein excretion and renal function with the use of nebivolol; and determine the number of patients that maintain or achieve a target blood pressure of ≤ 120/80 mmHg.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Transplant; Failure, Kidney, Hypertension
Keywords
kidney, transplant, hypertension, nebivolol, metoprolol, bystolic, toprol

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Nebivolol
Arm Type
Active Comparator
Arm Title
Metoprolol Succinate
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Nebivolol
Other Intervention Name(s)
Bystolic
Intervention Description
Subject will take nebivolol daily for 12 weeks.
Intervention Type
Drug
Intervention Name(s)
Metoprolol succinate
Other Intervention Name(s)
Toprol XL
Intervention Description
Subject will take metoprolol succinate daily for 12 weeks.
Primary Outcome Measure Information:
Title
Quality of Life
Description
Primary outcome measure will be the change from the Screening/Enrollment Visit to the End of the Study/Early Termination visit in scores of four quality of life questionnaires. The four quality of life questionnaires that were used included the following: Short Form (SF)-36v2 Health Survey (Score Range = 0-100; the lower the score the more disability) Sexual Dysfunction Tool for Men = International Index of Erectile Function (IIEF) Questionnaire (Score Range = 5-25; a score of 22-25 = No erectile dysfunction; 17-21 = Mild erectile dysfunction; 12-16 = Mild to moderate erectile dysfunction; 8-11 = Moderate erectile dysfunction; 5-7 = Severe erectile dysfunction) Sexual Dysfunction Tool for Women = Changes in Sexual Functioning Questionnaire (CSFQ-14-F; Score Range = 14-70; a score at or below 42 is indicative of sexual dysfunction) Multidimensional Assessment of Fatigue (MAF) Scale (Score Range = 1-50; the higher the score the more fatigue)
Time Frame
12 weeks; Baseline scores were measured at the Initial Screening/Enrollment Visit (Visit 1 - beginning of week 1); Follow-Up scores were measured at the End of the Study (Visit 2 - End of week 12)
Secondary Outcome Measure Information:
Title
Blood Pressure
Description
Evaluate the baseline and follow-up systolic and diastolic blood pressures for all subjects in both groups.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult renal transplant recipients, men and women between 18 and 75 years of age, inclusive. Patients must be > 3 months post-transplant. Patients must have stable renal function (stable renal function will be defined as those patients without infection or hospitalization [for any reason] over the past 30 days, and patients with < 20% change in their serum creatinine over the past 30 days. Patients receiving corticosteroids must be receiving a daily dose of < 7.5 mg of prednisone (or therapeutic equivalents based on glucocorticoid equivalency scale). All eligible patients must be receiving antihypertensive medication management which must include metoprolol tartrate or metoprolol succinate. Patients may be on more than one medication to control their hypertension. Use of any other FDA-approved antihypertensive agent is permitted. All eligible patients will either be at goal blood pressure (<120/80 mmHg) or have Pre-hypertension (<140/90 mmHg) or Stage I hypertension (<160/100 mmHg) at the time of study inclusion. Patients who are able to comprehend and satisfactorily comply with protocol requirements. Patients who signed the written informed consent given prior to entering any study procedure. Exclusion Criteria: Patients with Stage II/uncontrolled hypertension (>159/99 mmHg). Patients with an easily identifiable etiology for fatigue (i.e. anemia, iron-deficiency, poor sleep patterns, etc.). Patients who have a medical condition that, in the Investigator's opinion, would expose them to an increased risk of a significant adverse event or interfere with assessments of safety and efficacy during the course of the trial (i.e. arrhythmia). Patients with any current malignancy, or any clinically significant hematological, endocrine, cardiovascular, hepatic, gastrointestinal or neurological disease (including any form of epilepsy). If there is a history of such disease but the condition has been stable for at least the past year and is judged by the investigator not to interfere with the patient's participation in the study, the patient may be included. Patients who are judged by the investigator to be unable or unlikely to follow the study protocol and complete all scheduled visits. Patients with any contraindications to beta blocker therapy as listed in the package labeling for both metoprolol succinate and nebivolol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven Gabardi, PharmD, FCCP, BCPS
Organizational Affiliation
Transplant Surgery
Official's Role
Principal Investigator
Facility Information:
Facility Name
Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Lahey Clinic
City
Burlington
State/Province
Massachusetts
ZIP/Postal Code
01805
Country
United States

12. IPD Sharing Statement

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The Impact of Nebivolol Versus Metoprolol on Quality of Life

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