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Cicletanine in Hypertension With Diabetes: Added Magnesium Preserves Potassium and Sodium (CHAMP)

Primary Purpose

Arterial Hypertension, Diabetes, Hypokalemia

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Cicletanine + magnesium
Cicletanine
Sponsored by
Navitas Pharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Arterial Hypertension focused on measuring Cicletanine, Magnesium, Metabolic disease

Eligibility Criteria

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

Inclusion Criteria:

  1. Sitting SBP (systolic blood pressure) > 150 mmHg (millimeters of mercury) after five minutes' rest.
  2. Type II diabetes, with HbA1c between 8.5 and 11.5%. If a patient at screening presents outside of this range, the investigator may elect to re-screen a patient once to determine further the patient's eligibility.
  3. Age >18 and < 80 years of age
  4. BMI between 20 and 35, inclusive
  5. Have been stable on existing therapy for at least 30 days prior to initiation of cicletanine (Visit 2)

    a. no change in antihypertensive nor antihyperglycemia agent dose within 30 days prior to screening visit.

  6. Willing to comply with the requirements of the protocol.
  7. Willing to provide written Informed Consent to participate in the study approved by an appropriately constituted IRB (Institutional Review Board).
  8. All females who are not post-menopausal should be using at least two forms of contraception during the entire study.

Exclusion Criteria:

  1. Use of potassium supplementation over the past 30 days
  2. Use of potassium-wasting diuretics, e. g., thiazides over the past 30 days
  3. AST (aspartate aminotransferase; also abbreviated SGOT) outside normal range of 5 and 40 mg/dL inclusive
  4. ALT (alanine aminotransferase; also abbreviated SGPT) outside normal range of 7 and 56 mg/dL inclusive
  5. Laboratory findings outside of normal range can be considered grounds for exclusion at the discretion of the Sponsor, Medical Monitor and / or Principal Investigator
  6. History of or positive laboratory test for HIV, HBV (hepatitis B virus) or HCV (hepatitis C virus)
  7. Clinically significant psychiatric, addictive or neurologic disease or any other condition that, in the Investigator's opinion, would compromise his/her ability to give informed consent, participate fully in this study, or prevent adherence to the requirements of the study protocol
  8. Evidence of unstable cardiovascular disease including intermittent atrial fibrillation or unstable angina within the 4 weeks prior to screening
  9. History of myocardial infarction, coronary artery bypass graft surgery, or percutaneous cardiac intervention within the last 3 months
  10. Clinically significant valvular heart disease in the opinion of the Investigator
  11. History of cerebrovascular accident or transient ischemic attack within the last 3 months
  12. Presence or history of malignancy that required significant medical intervention within the preceding 3 months and/or is likely to result in death within the next 2 years
  13. Chronic renal impairment or renal insufficiency defined by a serum creatinine ³ 2.5 mEq/dL and/or the requirement for dialysis
  14. The subject is lactating, breastfeeding, or pregnant
  15. The subject has received any investigational medication within 30 days prior to the start of this study or be scheduled to receive another investigational drug during the course of this study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Experimental

    Arm Label

    Cicletanine

    Cicletanine + magnesium

    Arm Description

    Patients will take escalating doses of cicletanine

    Patients will take escalating doses of cicletanine; patients will in addition take magnesium

    Outcomes

    Primary Outcome Measures

    Time to potassium rescue
    The primary endpoint is the preservation of potassium levels at or above 3.3 mEq/L (milliequivalents per liter). A time to event model using the Log Rank test will be used to compare the Mg Group and those in the Non-Mg Group.

    Secondary Outcome Measures

    Reduction in systolic blood pressure vs. baseline
    Aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible.
    Reduction in diastolic blood pressure vs. baseline
    Aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible.
    Reduction in HbA1c vs. baseline
    Aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible.
    CRP (C reactive protein) levels
    CRP (C-reactive protein) is a measure of general inflammation. This will be an aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible.
    Average levels of potassium in patients on cicletanine with and without magnesium
    The average potassium levels levels in the two groups (cicletanine + magnesium; cicletanine only) will be compared. Subgroup analyses will also be made as feasible.
    Average levels of sodium in patients on cicletanine with and without magnesium
    The average sodium levels levels in the two groups (cicletanine + magnesium; cicletanine only) will be compared. Subgroup analyses will also be made as feasible.
    Average levels of magnesium in patients on cicletanine with and without magnesium
    The average magnesium levels levels in the two groups (cicletanine + magnesium; cicletanine only) will be compared. Subgroup analyses will also be made as feasible.

    Full Information

    First Posted
    March 10, 2016
    Last Updated
    August 30, 2021
    Sponsor
    Navitas Pharma
    Collaborators
    IndiPharm Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02709031
    Brief Title
    Cicletanine in Hypertension With Diabetes: Added Magnesium Preserves Potassium and Sodium
    Acronym
    CHAMP
    Official Title
    Cicletanine in Hypertension With Diabetes: Added Magnesium Preserves Potassium and Sodium
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2021
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    June 2022 (Anticipated)
    Primary Completion Date
    June 2024 (Anticipated)
    Study Completion Date
    September 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Navitas Pharma
    Collaborators
    IndiPharm Inc.

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Cicletanine, which has been approved and launched for hypertension in France and Germany, has promise beyond hypertension in critically-unmet needs such as diabetes. It is evident from in vitro, animal and human studies that cicletanine's optimal dose in diabetes and other challenging, critically-unmet needs is likely to be higher than that for hypertension. Cicletanine's maximum tolerated dosage is not known, but the drug's dose-limiting effects are documented to be potassium loss and sodium loss from thiazide-type activity (one of the therapeutic mechanisms the drug is known to have); such thiazide-type losses are known to be reversed safely by magnesium. This trial explores the ability of magnesium to enhance cicletanine safety at higher doses in a trial involving patients with hypertension complicated by diabetes.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Arterial Hypertension, Diabetes, Hypokalemia, Hyponatremia
    Keywords
    Cicletanine, Magnesium, Metabolic disease

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    24 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Cicletanine
    Arm Type
    Active Comparator
    Arm Description
    Patients will take escalating doses of cicletanine
    Arm Title
    Cicletanine + magnesium
    Arm Type
    Experimental
    Arm Description
    Patients will take escalating doses of cicletanine; patients will in addition take magnesium
    Intervention Type
    Drug
    Intervention Name(s)
    Cicletanine + magnesium
    Intervention Description
    Cicletanine is an orally-dosed furopyridine drug launched or hypertension in France in 1988 (and soon thereafter in Germany by IPSEN. While the drug's maximum tolerated dose is not known, the principal concern (and so far only material concern) at higher doses is the decrease in levels of sodium and potassium. Trials so far have take n the drug up to 400 mg QD (once daily); it was well tolerated at that dose. The drug has had an excellent safety profile in its ~1.8 million patient-years of post-launch experience, Magnesium is being added to cicletanine in order to decrease losses of potassium and sodium, thereby enhancing cicletanine's safety at higher doses.
    Intervention Type
    Drug
    Intervention Name(s)
    Cicletanine
    Intervention Description
    Cicletanine is an orally-dosed furopyridine drug launched or hypertension in France in 1988 (and soon thereafter in Germany by IPSEN. While the drug's maximum tolerated dose is not known, the principal concern (and so far only material concern) at higher doses is the decrease in levels of sodium and potassium. Trials so far have take n the drug up to 400 mg QD; it was well tolerated at that dose. The drug has had an excellent safety profile in its ~1.8 million patient-years of post-launch experience,
    Primary Outcome Measure Information:
    Title
    Time to potassium rescue
    Description
    The primary endpoint is the preservation of potassium levels at or above 3.3 mEq/L (milliequivalents per liter). A time to event model using the Log Rank test will be used to compare the Mg Group and those in the Non-Mg Group.
    Time Frame
    13 weeks (duration of study)
    Secondary Outcome Measure Information:
    Title
    Reduction in systolic blood pressure vs. baseline
    Description
    Aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible.
    Time Frame
    13 weeks (duration of study)
    Title
    Reduction in diastolic blood pressure vs. baseline
    Description
    Aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible.
    Time Frame
    13 weeks (duration of study)
    Title
    Reduction in HbA1c vs. baseline
    Description
    Aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible.
    Time Frame
    13 weeks (duration of study)
    Title
    CRP (C reactive protein) levels
    Description
    CRP (C-reactive protein) is a measure of general inflammation. This will be an aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible.
    Time Frame
    13 weeks (duration of study)
    Title
    Average levels of potassium in patients on cicletanine with and without magnesium
    Description
    The average potassium levels levels in the two groups (cicletanine + magnesium; cicletanine only) will be compared. Subgroup analyses will also be made as feasible.
    Time Frame
    13 weeks (duration of study)
    Title
    Average levels of sodium in patients on cicletanine with and without magnesium
    Description
    The average sodium levels levels in the two groups (cicletanine + magnesium; cicletanine only) will be compared. Subgroup analyses will also be made as feasible.
    Time Frame
    13 weeks (duration of study)
    Title
    Average levels of magnesium in patients on cicletanine with and without magnesium
    Description
    The average magnesium levels levels in the two groups (cicletanine + magnesium; cicletanine only) will be compared. Subgroup analyses will also be made as feasible.
    Time Frame
    13 weeks (duration of study)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    80 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Sitting SBP (systolic blood pressure) > 150 mmHg (millimeters of mercury) after five minutes' rest. Type II diabetes, with HbA1c between 8.5 and 11.5%. If a patient at screening presents outside of this range, the investigator may elect to re-screen a patient once to determine further the patient's eligibility. Age >18 and < 80 years of age BMI between 20 and 35, inclusive Have been stable on existing therapy for at least 30 days prior to initiation of cicletanine (Visit 2) a. no change in antihypertensive nor antihyperglycemia agent dose within 30 days prior to screening visit. Willing to comply with the requirements of the protocol. Willing to provide written Informed Consent to participate in the study approved by an appropriately constituted IRB (Institutional Review Board). All females who are not post-menopausal should be using at least two forms of contraception during the entire study. Exclusion Criteria: Use of potassium supplementation over the past 30 days Use of potassium-wasting diuretics, e. g., thiazides over the past 30 days AST (aspartate aminotransferase; also abbreviated SGOT) outside normal range of 5 and 40 mg/dL inclusive ALT (alanine aminotransferase; also abbreviated SGPT) outside normal range of 7 and 56 mg/dL inclusive Laboratory findings outside of normal range can be considered grounds for exclusion at the discretion of the Sponsor, Medical Monitor and / or Principal Investigator History of or positive laboratory test for HIV, HBV (hepatitis B virus) or HCV (hepatitis C virus) Clinically significant psychiatric, addictive or neurologic disease or any other condition that, in the Investigator's opinion, would compromise his/her ability to give informed consent, participate fully in this study, or prevent adherence to the requirements of the study protocol Evidence of unstable cardiovascular disease including intermittent atrial fibrillation or unstable angina within the 4 weeks prior to screening History of myocardial infarction, coronary artery bypass graft surgery, or percutaneous cardiac intervention within the last 3 months Clinically significant valvular heart disease in the opinion of the Investigator History of cerebrovascular accident or transient ischemic attack within the last 3 months Presence or history of malignancy that required significant medical intervention within the preceding 3 months and/or is likely to result in death within the next 2 years Chronic renal impairment or renal insufficiency defined by a serum creatinine ³ 2.5 mEq/dL and/or the requirement for dialysis The subject is lactating, breastfeeding, or pregnant The subject has received any investigational medication within 30 days prior to the start of this study or be scheduled to receive another investigational drug during the course of this study

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Cicletanine in Hypertension With Diabetes: Added Magnesium Preserves Potassium and Sodium

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