A Study to Evaluate the Effects of Azilsartan on Coronary Artery Plaque in Essential Hypertensive Patients With Stable Angina and Dyslipidemia. (ALIVE)
Primary Purpose
Essential Hypertension With Stable Angina and Dyslipidemia
Status
Withdrawn
Phase
Phase 4
Locations
Japan
Study Type
Interventional
Intervention
Azilsartan
Sponsored by
About this trial
This is an interventional treatment trial for Essential Hypertension With Stable Angina and Dyslipidemia focused on measuring Pharmacotherapy
Eligibility Criteria
Inclusion Criteria:
Patients with essential hypertension with office blood pressure before the start of study treatment (Week 0) meeting the following criteria who are appropriate for azilsartan therapy in the opinion of the principal investigator or investigator
- Patients aged ≥ 75 years at the time of informed consent: Sitting systolic blood pressure ≥ 150 mmHg or sitting diastolic blood pressure ≥ 90 mmHg
- Patients aged < 75 years at the time of informed consent who concurrently have type 2 diabetes mellitus: Sitting systolic blood pressure ≥ 130 mmHg or sitting diastolic blood pressure ≥ 80 mmHg
- Patients aged < 75 years at the time of informed consent who concurrently have chronic kidney disease (CKD) with proteinuria: Sitting systolic blood pressure ≥ 130 mmHg or sitting diastolic blood pressure ≥ 80 mmHg
- Patients meeting none of the above: Sitting systolic blood pressure ≥ 140 mmHg or sitting diastolic blood pressure ≥ 90 mmHg
- Patients with stable angina with a coronary stenosis confirmed by coronary angiography who are planned to undergo percutaneous coronary intervention with stent placement (any type of stent)
- Patients with findings of integrated backscatter intravascular ultrasound (IB-IVUS) to be performed before the start of study treatment (Week 0) showing plaque at (≥ 5 mm in length) ≥ 5 mm proximal to the proximal end of the inserted stent in the coronary artery
Patients with dyslipidemia meeting both of the following criteria:
- Patients treated with one HMG-CoA reductase inhibitor with no change in the dosage for at least 12 weeks before informed consent
- Patients with an LDL-C level of < 100 mg/dL as shown by a laboratory test performed within 4 weeks before informed consent
- Men or women aged 20 or older at the time of informed consent
- Patients capable of making outpatient study visits throughout the observation period
- Patients who, in the opinion of the principal investigator or investigator, are capable of understanding the contents of the clinical study and complying with the study requirements
- Patients capable of providing written consent in person before any study procedures
Exclusion Criteria:
- Patients with secondary hypertension or malignant hypertension
- Patients who took any renin-angiotensin system inhibitor within 12 weeks before informed consent
- Patients who previously underwent coronary artery bypass grafting
- Patients with type 1 diabetes mellitus
- Patients with insulin therapy
- Patients with an HbA1c level (National Glycohemoglobin Standardization Program [NGSP] value) of ≥ 7.0% as shown by a laboratory test performed within 4 weeks before informed consent
- Patients with the plaque unevaluable because of severe calcification of the coronary artery shown by IB-IVUS to be performed before the start of study treatment (Week 0)
- Patients with a change to their antidyslipidemic medication (including a change to the dosage) within 12 weeks before informed consent
- Patients with clinically evident renal disorder (defined as estimated glomerular filtration rate < 30 mL/min/1.73m2)
- Patients with severe liver disorder
- Patients with hyperkalemia (defined as serum potassium ≥ 5.5 mEq/L)
- Patients with a history of hypersensitivity or allergy to azilsartan
- Patients participating in any other clinical study
- Pregnant women, women with possible pregnancy, or breastfeeding women
- Other patients who are inappropriate for participation in this study in the opinion of the principal investigator or investigator
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Azilsartan
Arm Description
Azilsartan orally once daily in the morning, either before or after breakfast
Outcomes
Primary Outcome Measures
Change in percentage of the lipid pool in the coronary artery plaque
Change in percentage of the lipid pool in the coronary artery plaque from the start of the treatment period at the end of the treatment period (Week 32).
Percentage of the lipid pool in the coronary artery plaque is measured by integrated backscatter intravascular ultrasound (IB-IVUS).
Secondary Outcome Measures
Change in volume of the coronary artery plaque
Change in the volume of the coronary artery plaque from the start of the treatment period to the end of the treatment period.
Change from baseline in volume of the coronary artery plaque is measured by integrated backscatter intravascular ultrasound (IB-IVUS).
Change in percentage of the fibrotic component in the coronary artery plaque
Change in percentage of the fibrotic component in the coronary artery plaque from the start of the treatment period at the end of the treatment period (Week 32).
Percentage of the fibrotic component in the coronary artery plaque is measured by integrated backscatter intravascular ultrasound (IB-IVUS).
Change in percentage of the calcified component in the coronary artery plaque
Change in percentage of the calcified component in the coronary artery plaque from the start of the treatment period at the end of the treatment period (Week 32).
Percentage of the calcified component in the coronary artery plaque is measured by integrated backscatter intravascular ultrasound (IB-IVUS).
Change in number of microchannels
Change from baseline in number of microchannels is measured by Optical Coherence Tomography(OCT).
Change in thickness of the fibrous cap
Change from baseline in number of microchannels is measured by Optical Coherence Tomography(OCT).
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02400775
Brief Title
A Study to Evaluate the Effects of Azilsartan on Coronary Artery Plaque in Essential Hypertensive Patients With Stable Angina and Dyslipidemia.
Acronym
ALIVE
Official Title
A Study to Evaluate the Effects of Azilsartan on Coronary Artery Plaque in Essential Hypertensive Patients With Stable Angina and Dyslipidemia.
Study Type
Interventional
2. Study Status
Record Verification Date
May 2016
Overall Recruitment Status
Withdrawn
Study Start Date
March 2015 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
April 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Takeda
4. Oversight
5. Study Description
Brief Summary
The purpose of this study is to evaluate the effects of oral azilsartan once daily for 32 weeks on coronary artery plaque in essential hypertensive patients with stable angina and dyslipidemia.
Detailed Description
The open-label design without a control group was selected because this clinical study primarily aims to explore the effects of azilsartan on coronary artery plaques.
This study targeting patients with coronary artery plaque has been designed to enroll hypertensive patients with dyslipidemia. Also in light of the invasive nature of the major assessment procedures (i.e., IB-IVUS, OCT), this study will only enroll patients with stable angina planned to undergo percutaneous coronary intervention with stent placement, among patients with coronary artery plaque.
The starting dose of azilsartan has been set to 20 mg on the basis of the usual clinical dose of the drug in patients with essential hypertension, and dose increase of azilsartan will be permitted only when the target blood pressure has not been achieved.
The duration of treatment has been set to 32 weeks in line with clinical practice, in which coronary angiography is typically performed after a 32-week follow-up period following PCI with stent placement.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Essential Hypertension With Stable Angina and Dyslipidemia
Keywords
Pharmacotherapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Azilsartan
Arm Type
Experimental
Arm Description
Azilsartan orally once daily in the morning, either before or after breakfast
Intervention Type
Drug
Intervention Name(s)
Azilsartan
Other Intervention Name(s)
Azilva tablets
Intervention Description
Azilsartan tablets
Primary Outcome Measure Information:
Title
Change in percentage of the lipid pool in the coronary artery plaque
Description
Change in percentage of the lipid pool in the coronary artery plaque from the start of the treatment period at the end of the treatment period (Week 32).
Percentage of the lipid pool in the coronary artery plaque is measured by integrated backscatter intravascular ultrasound (IB-IVUS).
Time Frame
32 weeks
Secondary Outcome Measure Information:
Title
Change in volume of the coronary artery plaque
Description
Change in the volume of the coronary artery plaque from the start of the treatment period to the end of the treatment period.
Change from baseline in volume of the coronary artery plaque is measured by integrated backscatter intravascular ultrasound (IB-IVUS).
Time Frame
32 weeks
Title
Change in percentage of the fibrotic component in the coronary artery plaque
Description
Change in percentage of the fibrotic component in the coronary artery plaque from the start of the treatment period at the end of the treatment period (Week 32).
Percentage of the fibrotic component in the coronary artery plaque is measured by integrated backscatter intravascular ultrasound (IB-IVUS).
Time Frame
32 weeks
Title
Change in percentage of the calcified component in the coronary artery plaque
Description
Change in percentage of the calcified component in the coronary artery plaque from the start of the treatment period at the end of the treatment period (Week 32).
Percentage of the calcified component in the coronary artery plaque is measured by integrated backscatter intravascular ultrasound (IB-IVUS).
Time Frame
32 weeks
Title
Change in number of microchannels
Description
Change from baseline in number of microchannels is measured by Optical Coherence Tomography(OCT).
Time Frame
32 weeks
Title
Change in thickness of the fibrous cap
Description
Change from baseline in number of microchannels is measured by Optical Coherence Tomography(OCT).
Time Frame
32 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with essential hypertension with office blood pressure before the start of study treatment (Week 0) meeting the following criteria who are appropriate for azilsartan therapy in the opinion of the principal investigator or investigator
Patients aged ≥ 75 years at the time of informed consent: Sitting systolic blood pressure ≥ 150 mmHg or sitting diastolic blood pressure ≥ 90 mmHg
Patients aged < 75 years at the time of informed consent who concurrently have type 2 diabetes mellitus: Sitting systolic blood pressure ≥ 130 mmHg or sitting diastolic blood pressure ≥ 80 mmHg
Patients aged < 75 years at the time of informed consent who concurrently have chronic kidney disease (CKD) with proteinuria: Sitting systolic blood pressure ≥ 130 mmHg or sitting diastolic blood pressure ≥ 80 mmHg
Patients meeting none of the above: Sitting systolic blood pressure ≥ 140 mmHg or sitting diastolic blood pressure ≥ 90 mmHg
Patients with stable angina with a coronary stenosis confirmed by coronary angiography who are planned to undergo percutaneous coronary intervention with stent placement (any type of stent)
Patients with findings of integrated backscatter intravascular ultrasound (IB-IVUS) to be performed before the start of study treatment (Week 0) showing plaque at (≥ 5 mm in length) ≥ 5 mm proximal to the proximal end of the inserted stent in the coronary artery
Patients with dyslipidemia meeting both of the following criteria:
Patients treated with one HMG-CoA reductase inhibitor with no change in the dosage for at least 12 weeks before informed consent
Patients with an LDL-C level of < 100 mg/dL as shown by a laboratory test performed within 4 weeks before informed consent
Men or women aged 20 or older at the time of informed consent
Patients capable of making outpatient study visits throughout the observation period
Patients who, in the opinion of the principal investigator or investigator, are capable of understanding the contents of the clinical study and complying with the study requirements
Patients capable of providing written consent in person before any study procedures
Exclusion Criteria:
Patients with secondary hypertension or malignant hypertension
Patients who took any renin-angiotensin system inhibitor within 12 weeks before informed consent
Patients who previously underwent coronary artery bypass grafting
Patients with type 1 diabetes mellitus
Patients with insulin therapy
Patients with an HbA1c level (National Glycohemoglobin Standardization Program [NGSP] value) of ≥ 7.0% as shown by a laboratory test performed within 4 weeks before informed consent
Patients with the plaque unevaluable because of severe calcification of the coronary artery shown by IB-IVUS to be performed before the start of study treatment (Week 0)
Patients with a change to their antidyslipidemic medication (including a change to the dosage) within 12 weeks before informed consent
Patients with clinically evident renal disorder (defined as estimated glomerular filtration rate < 30 mL/min/1.73m2)
Patients with severe liver disorder
Patients with hyperkalemia (defined as serum potassium ≥ 5.5 mEq/L)
Patients with a history of hypersensitivity or allergy to azilsartan
Patients participating in any other clinical study
Pregnant women, women with possible pregnancy, or breastfeeding women
Other patients who are inappropriate for participation in this study in the opinion of the principal investigator or investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
General Manager
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Tokushima
Country
Japan
12. IPD Sharing Statement
Learn more about this trial
A Study to Evaluate the Effects of Azilsartan on Coronary Artery Plaque in Essential Hypertensive Patients With Stable Angina and Dyslipidemia.
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