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Evaluate the Efficacy and Safety of Pletaal (Cilostazol) in Subjects With Vasospastic Angina (STELLA)

Primary Purpose

Variant Angina

Status
Completed
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Placebo
Sponsored by
Korea Otsuka Pharmaceutical Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Variant Angina focused on measuring Variant angina, Cilostazol

Eligibility Criteria

20 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female over the age of 20 and under the age of 80
  2. Diagnosis of vasospastic angina
  3. At least one episode of chest pain weekly during the Amlodipine run in period for 2 weeks

Exclusion Criteria:

  1. Currently taking or has taken Cilostazol within the last 3 month before the screening.
  2. Taking oral antiplatelet agents such as Aspirin, Clopidogrel after Amlodipine run-in period.
  3. Oral anticoagulants such as Warfarin within the last a month before the screening.
  4. Currently taking any of the following medications or has taken any of the following medications within the last a week before the screening:

    • Other Calcium channel blockers than Amlodipine
    • Beta-blocker, or Alpha-blocker
    • Oral Nitrate, Nicorandil, except sublingual Nitroglycerin as required(PRN)
    • Vitamin E preparations
    • Estrogens
  5. History of Myocardial infarction or Myocardial infarction by vasospastic angina at screening
  6. History of life threatening vasospastic events such as ventricular tachycardia , ventricular fibrillation, or syncope
  7. History of stroke, intracranial hemorrhage, or Transient Ischemic Attack(TIA)
  8. Hemorrhage (hemophilia, capillary fragility, intracranial hemorrhage, upper gastrointestinal hemorrhage, urinary hemorrhage, hemoptysis, vitreous hemorrhage, etc.) or such tendency (active peptic ulcer, hemorrhagic stroke within past 6 months, a case hemorrhage is suspected by wound for surgery within 3 months, proliferative diabetic retinopathy and uncontrolled hypertension)
  9. History of clinically significant hypersensitivity to the substances of Cilostazol, Amlodipine, Nitroglycerin or dihydropyridine
  10. Patients with severe aortic valvular stenosis
  11. History of shock
  12. Hypotension of diastolic pressure < 90 mmHg at screening
  13. History of clinically significant hypersensitivity to the substances of Nitrates
  14. Patients with severe anemia of Hemoglobin ≤ 6.5 g/dl at screening
  15. History of glaucoma
  16. Electrocardiogram(ECG) abnormality precluding interpretation of ST change at screening
  17. Congestive heart failure with less than 40% of left ventricular ejection fraction within the last 3 month before the screening or screening period
  18. Atrial fibrillation or valvular heart disease, more than moderate severity
  19. Suspected or identified spasm of left main coronary artery, result of coronary angiography or coronary angiography in the ergonovine induced coronary spasm provocation test
  20. History of Coronary artery bypass graft(CABG) or percutaneous coronary intervention(PCI)
  21. Tachycardia; Heart rate > 100 bpm, at Screening
  22. Uncontrolled hypertension, defined as ≥ 160 mmHg systolic or ≥ 100 mmHg diastolic at Screening
  23. Creatinine ≥ 1.5 mg/dL at screening
  24. Aspartate transaminase (AST) or alanine transaminase (ALT) > 3 times the upper limit of normal (ULN) at screening
  25. Platelet < 100,000 mm3 at screening
  26. QT prolongation defined as baseline QTc > 450 msec for males or > 470 msec for females at Screening.
  27. Women who have the possible of pregnancy, or positive urine or blood pregnancy test at screening
  28. Women who are not using a reliable method of birth control, who are pregnant, or who are breast-feeding
  29. Drug compliance of Amlodipine < 80% during the Amlodipine run in period for 2 weeks
  30. Otherwise judged by the investigator to be inappropriate for inclusion in the trial.

Sites / Locations

  • Keimyung University Dongsan Medical Center
  • ChungNam Univ. Hospital
  • Gangneung Asan Hospital
  • Chonnam National University Hospital
  • Gyongsang National University Hospital
  • Dong-A University Hospital
  • Pusan National University Yansan Hospital
  • Asan Medical Center
  • Ajou University Hospital
  • Ulsan University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cilostazol

Arm Description

To investigate the efficacy and safety of Pletaal(Cilostazol) in comparison with placebo for 4 weeks in vasospastic angina patients who have an insufficient response to Amlodipine (Calcium channel blocker).

Outcomes

Primary Outcome Measures

Percent change of the chest pain frequency
Collect the chest pain frequency data related with vasospastic angina episodes by subject diaries. Descriptive statistics (N, mean, standard deviation, minimum, median and maximum) will be presented by treatment group. ANCOVA will be performed between the treatment groups using the baseline (a week before IP dosing) as covariate.

Secondary Outcome Measures

The chest pain frequency, the pain intensity, nitroglycerin consumption of the final a week after IP dosing from a week before IP dosing
Descriptive statistics (N, mean, standard deviation, minimum, median and maximum) will be presented by treatment group. ANCOVA will be performed between the treatment groups using the baseline (a week before IP dosing) as covariate. The subject who has no chest pain will be regarded as the total pain intensity and the average pain intensity are '0'. The subject who has taken no nitroglycerin will be regarded as taking '0' tablet.

Full Information

First Posted
September 27, 2011
Last Updated
July 13, 2012
Sponsor
Korea Otsuka Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01444885
Brief Title
Evaluate the Efficacy and Safety of Pletaal (Cilostazol) in Subjects With Vasospastic Angina
Acronym
STELLA
Official Title
A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel Group, Therapeutic Exploratory Study to Evaluate the Efficacy and Safety of PletaalÒ(Cilostazol) in Subjects With Vasospastic Angina (STELLA)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2012
Overall Recruitment Status
Completed
Study Start Date
October 2011 (undefined)
Primary Completion Date
July 2012 (Actual)
Study Completion Date
July 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Korea Otsuka Pharmaceutical Co., Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to investigate the efficacy and safety of Pletaal (Cilostazol) in comparison with placebo for 4 weeks in vasospastic angina patients who have an insufficient response to Amlodipine (Calcium channel blocker).
Detailed Description
A Multicenter, Randomized, Double-Blind, Placebo-controlled, Parallel group, Therapeutic exploratory Study. The subject who has at least an episode of chest pain weekly despite Amlodipine 5mg once a day (qd) taking during 2 weeks will have treatment of Pletaal (Cilostazol) or Placebo for 4 weeks. Pletaal (Cilostazol) is taken 100mg oral tablets two times a day (bid) during 2 weeks after dosing of Pletaal (Cilostazol) 50mg oral tablets bid during 2 weeks. Placebo of Pletaal (Cilostazol) is used as the control medication.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Variant Angina
Keywords
Variant angina, Cilostazol

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
50 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cilostazol
Arm Type
Experimental
Arm Description
To investigate the efficacy and safety of Pletaal(Cilostazol) in comparison with placebo for 4 weeks in vasospastic angina patients who have an insufficient response to Amlodipine (Calcium channel blocker).
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Amlodipine, Nitroglycerin
Intervention Description
2 weeks treatment of Cilostazol 100mg, or placebo oral tablets bid after 2 weeks treatment of Cilostazol 50mg, or placebo oral tablets bid (Total 4 weeks)
Primary Outcome Measure Information:
Title
Percent change of the chest pain frequency
Description
Collect the chest pain frequency data related with vasospastic angina episodes by subject diaries. Descriptive statistics (N, mean, standard deviation, minimum, median and maximum) will be presented by treatment group. ANCOVA will be performed between the treatment groups using the baseline (a week before IP dosing) as covariate.
Time Frame
A week before IP dosing and the final a week after IP dosing (average 6weeks)
Secondary Outcome Measure Information:
Title
The chest pain frequency, the pain intensity, nitroglycerin consumption of the final a week after IP dosing from a week before IP dosing
Description
Descriptive statistics (N, mean, standard deviation, minimum, median and maximum) will be presented by treatment group. ANCOVA will be performed between the treatment groups using the baseline (a week before IP dosing) as covariate. The subject who has no chest pain will be regarded as the total pain intensity and the average pain intensity are '0'. The subject who has taken no nitroglycerin will be regarded as taking '0' tablet.
Time Frame
A week before IP dosing and the final a week after IP dosing (average 6weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female over the age of 20 and under the age of 80 Diagnosis of vasospastic angina At least one episode of chest pain weekly during the Amlodipine run in period for 2 weeks Exclusion Criteria: Currently taking or has taken Cilostazol within the last 3 month before the screening. Taking oral antiplatelet agents such as Aspirin, Clopidogrel after Amlodipine run-in period. Oral anticoagulants such as Warfarin within the last a month before the screening. Currently taking any of the following medications or has taken any of the following medications within the last a week before the screening: Other Calcium channel blockers than Amlodipine Beta-blocker, or Alpha-blocker Oral Nitrate, Nicorandil, except sublingual Nitroglycerin as required(PRN) Vitamin E preparations Estrogens History of Myocardial infarction or Myocardial infarction by vasospastic angina at screening History of life threatening vasospastic events such as ventricular tachycardia , ventricular fibrillation, or syncope History of stroke, intracranial hemorrhage, or Transient Ischemic Attack(TIA) Hemorrhage (hemophilia, capillary fragility, intracranial hemorrhage, upper gastrointestinal hemorrhage, urinary hemorrhage, hemoptysis, vitreous hemorrhage, etc.) or such tendency (active peptic ulcer, hemorrhagic stroke within past 6 months, a case hemorrhage is suspected by wound for surgery within 3 months, proliferative diabetic retinopathy and uncontrolled hypertension) History of clinically significant hypersensitivity to the substances of Cilostazol, Amlodipine, Nitroglycerin or dihydropyridine Patients with severe aortic valvular stenosis History of shock Hypotension of diastolic pressure < 90 mmHg at screening History of clinically significant hypersensitivity to the substances of Nitrates Patients with severe anemia of Hemoglobin ≤ 6.5 g/dl at screening History of glaucoma Electrocardiogram(ECG) abnormality precluding interpretation of ST change at screening Congestive heart failure with less than 40% of left ventricular ejection fraction within the last 3 month before the screening or screening period Atrial fibrillation or valvular heart disease, more than moderate severity Suspected or identified spasm of left main coronary artery, result of coronary angiography or coronary angiography in the ergonovine induced coronary spasm provocation test History of Coronary artery bypass graft(CABG) or percutaneous coronary intervention(PCI) Tachycardia; Heart rate > 100 bpm, at Screening Uncontrolled hypertension, defined as ≥ 160 mmHg systolic or ≥ 100 mmHg diastolic at Screening Creatinine ≥ 1.5 mg/dL at screening Aspartate transaminase (AST) or alanine transaminase (ALT) > 3 times the upper limit of normal (ULN) at screening Platelet < 100,000 mm3 at screening QT prolongation defined as baseline QTc > 450 msec for males or > 470 msec for females at Screening. Women who have the possible of pregnancy, or positive urine or blood pregnancy test at screening Women who are not using a reliable method of birth control, who are pregnant, or who are breast-feeding Drug compliance of Amlodipine < 80% during the Amlodipine run in period for 2 weeks Otherwise judged by the investigator to be inappropriate for inclusion in the trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
June Hong Kim, MD
Organizational Affiliation
Pusan National University Yansan Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Keimyung University Dongsan Medical Center
City
Daegu
Country
Korea, Republic of
Facility Name
ChungNam Univ. Hospital
City
DaeJeon
Country
Korea, Republic of
Facility Name
Gangneung Asan Hospital
City
Gangneung
Country
Korea, Republic of
Facility Name
Chonnam National University Hospital
City
Gwangju
Country
Korea, Republic of
Facility Name
Gyongsang National University Hospital
City
Jinjoo
Country
Korea, Republic of
Facility Name
Dong-A University Hospital
City
Pusan
Country
Korea, Republic of
Facility Name
Pusan National University Yansan Hospital
City
Pusan
Country
Korea, Republic of
Facility Name
Asan Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Ajou University Hospital
City
Suwon
Country
Korea, Republic of
Facility Name
Ulsan University Hospital
City
Ulsan
Country
Korea, Republic of

12. IPD Sharing Statement

Citations:
PubMed Identifier
24934484
Citation
Shin ES, Lee JH, Yoo SY, Park Y, Hong YJ, Kim MH, Lee JY, Nam CW, Tahk SJ, Kim JS, Jeong YH, Lee CW, Shin HK, Kim JH. A randomised, multicentre, double blind, placebo controlled trial to evaluate the efficacy and safety of cilostazol in patients with vasospastic angina. Heart. 2014 Oct;100(19):1531-6. doi: 10.1136/heartjnl-2014-305986. Epub 2014 Jun 16.
Results Reference
derived

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Evaluate the Efficacy and Safety of Pletaal (Cilostazol) in Subjects With Vasospastic Angina

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