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Comparison of Efficacy and Safety of Combination Therapy and Monotherapy of Candesartan and Amlodipine for Dose-Finding in Patients With Essential Hypertension

Primary Purpose

Essential Hypertension

Status
Completed
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Candesartan Cilexetil 8mg
Candesartan Cilexetil 16mg
Amlodipine 5mg
Amlodipine 10mg
Sponsored by
Shin Poong Pharmaceutical Co. Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Essential Hypertension focused on measuring Candesartan, Amlodipine, Hypertension, Vascular Diseases, Cardiovascular Diseases, Antihypertensive Agents, Vasodilator Agents, Angiotensin II Type 1 Receptor Blockers, Angiotensin Receptor Antagonists, Calcium Channel Blockers

Eligibility Criteria

19 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female patients greater than or equal to 19 years of age
  2. Subject who was diagnosed with essential hypertension or after administer the antihypertensive drug (Subject who may temporarily suspend antihypertensive treatment based on doctor's decision)
  3. Subject who have voluntarily agreed to participate in the trial and signed the written informed consent form

Exclusion Criteria:

  1. Subject with severe hypertension (in a selected arm with msSBP ≥ 200 mmHg or msDBP ≥ 115 mmHg) during the Screening and Randomized Trial.
  2. Subject with difference of the blood pressure of over 20 mmHg for SBP or 10 mmHg for diastolic blood pressure (DSP) between three consecutive measurements in a selected arm during the screening visit
  3. Secondary hypertension (such as, coarctation of the aorta, primary hyperaldosteronism, renal artery stenosis, Cushing's disease, pheochromocytoma, polycystic kidney disease, etc.)
  4. Symptomatic orthostatic hypotension
  5. Severe heart failure( New York Heart Association(NYHA) Class III/IV)
  6. Subject with acute coronary syndrome(myocardial infarction or unstable angina), peripheral vascular disease within the past 6 months
  7. History of switching to another Antiarrhythmic drugs(not including electrolyte correction), or received Cardioversion or ICU treatment within the past 6 months
  8. Type 1 diabetes mellitus or Uncontrolled Type 2 diabetes mellitus (HbA1c > 9.0%)
  9. Subject with Haemodynamic disturbance, heart valve disease with structural defects
  10. Severe cerebrovascular disease (stroke, cerebral infarction, or cerebral hemorrhage, etc. within the past 6 months)
  11. Severe eye disease (retinal hemorrhage, visual impairment, retinal microaneurysm, etc. within the past 6 months)
  12. Autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, etc.)
  13. Chronic inflammatory disease requiring continuous anti-inflammatory treatment
  14. Clinically significant Renal or liver impairment, or laboratory abnormalities such as Ccr: below 30ml/min or Aspartate Aminotransferase (AST) or Alanine Aminotransferase (ALT) > 3 x Upper Limit Normal (ULN)
  15. Hypokalaemia(Serum potassium < 3.5 mmol/L) or hyperkalaemia(Serum potassium > 5.5 mmol/L)
  16. Subject with gastrointestinal disease(such as Crohn's disease, gastric ulcer, acute or chronic pancreatitis) or history of gastrointestinal surgery(not including appendectomy or hernia surgery) that might significantly alter the absorption of the drug
  17. history of allergy or hypersensitivity to Angiotensin II Receptor Blockers(Candesartan) or Calcium Channel Blocker(amlodipine)
  18. Subject with heredity defects such as galactose intolerance, Lapp lactose deficiency, or glucose-galactose malabsorption
  19. Subject requiring concomitant use of other antihypertensive or contraindicated drugs( Tizanidine, dolasetron, Itraconazole, potassium, potassium-sparing diuretics, etc.) during the clinical trial
  20. history of malignant tumors within the past 5 years
  21. history of alcohol or drug abuse
  22. Pregnant women and lactating mothers
  23. Women who is planning to be pregnant during or 2 months after the study, or women or men who are not using medically acceptable methods of contraception *

    * progestin oral or implant contraceptive, intra-uterine device, condom, partner with surgical sterilization, etc.

  24. Use of other investigational products within the past 1 month
  25. Subject who are judged by the investigator unsuitable to participate in the study

Sites / Locations

  • Catholic University of Korea Bucheon St. Mary's Hospital
  • Inje University Busan Paik Hospital
  • Pusan National University Hospital
  • Keimyung University Dongsan Medical Center
  • Kyungpook National University Hospital
  • Daegu Catholic University Medical Center
  • Dongguk University Ilsan Hospital
  • Chonnam National University Hospital
  • Catholic University of Korea Uijeongbu St. Mary's hospital
  • Gachon University Gil Hospital
  • St. Carollo General Hospital
  • Wonju Severance Christian Hospital
  • Catholic University of Korea St. Paul's Hospital
  • KyungHee University Medical Center
  • Hallym University Kangdong Sacred Heart Hospital
  • Kyung Hee University Hospital at Gangdong
  • VHS( Veterans Medical Service) Medical Center
  • Konkuk University Medical Center
  • Seoul National University Hospital
  • Catholic University of Korea Seoul St. Mary's Hospital
  • Korea University Anam Hospital
  • Catholic University of Korea Yeouido St. Mary's Hospital
  • Ulsan University Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Candesartan Cilexetil (CC) 8mg

CC 16mg

Amlodipine(AML) 5mg

AML 10mg

CC 8mg / AML 5mg

CC 8mg / AML 10mg

CC 16mg / AML 5mg

CC 16mg / AML 10mg

Arm Description

Candesartan Cilexetil 8mg, once a day for 8 weeks

Candesartan Cilexetil 16mg, once a day for 8 weeks

Amlodipine 5mg, once a day for 8 weeks

Amlodipine 10mg, once a day for 8 weeks

Candesartan 8mg and Amlodipine 5mg, once a day for 8 weeks

Candesartan 8mg and Amlodipine 10mg, once a day for 8 weeks

Candesartan 16mg and Amlodipine 5mg, once a day for 8 weeks

Candesartan 16mg and Amlodipine 10mg, once a day for 8 weeks

Outcomes

Primary Outcome Measures

Change mean sitting Diastolic Blood Pressure (msDBP) at week 8 compared to baseline

Secondary Outcome Measures

Change mean sitting Diastolic Blood Pressure (msDBP) at week 4 compared to baseline
Change mean sitting Systolic Blood Pressure (msSBP) at week 4 and 8 compared to baseline
Proportion of patients achieving treatment goal at week 4 and 8: < 140/90 mmHg
Joint National Committee VII Guideline Treatment goal: < 140/90 mmHg (< 130/80 mmHg, diabetic or chronic renal failure patient)
Blood Pressure Response rate at week 4 and 8: msSBP reduction ≥ 20 mmHg and msDBP reduction ≥ 10 mmHg

Full Information

First Posted
October 24, 2016
Last Updated
November 21, 2016
Sponsor
Shin Poong Pharmaceutical Co. Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02944734
Brief Title
Comparison of Efficacy and Safety of Combination Therapy and Monotherapy of Candesartan and Amlodipine for Dose-Finding in Patients With Essential Hypertension
Official Title
A Multi-center, Randomized, Double-blind, Phase II Clinical Trial to Evaluate the Efficacy and Safety of Combination Therapy vs. Monotherapy of Candesartan and Amlodipine for Dose-Finding in Patients With Essential Hypertension
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Completed
Study Start Date
September 2014 (undefined)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shin Poong Pharmaceutical Co. Ltd.

4. Oversight

5. Study Description

Brief Summary
The purpose of this study is to explore the optimal dose of fixed-dose combination of candesartan cilexetil and amlodipine besylate by examining the safety and efficacy of the combination therapy compared to each of the monotherapy in patients with essential hypertension.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Essential Hypertension
Keywords
Candesartan, Amlodipine, Hypertension, Vascular Diseases, Cardiovascular Diseases, Antihypertensive Agents, Vasodilator Agents, Angiotensin II Type 1 Receptor Blockers, Angiotensin Receptor Antagonists, Calcium Channel Blockers

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Candesartan Cilexetil (CC) 8mg
Arm Type
Experimental
Arm Description
Candesartan Cilexetil 8mg, once a day for 8 weeks
Arm Title
CC 16mg
Arm Type
Experimental
Arm Description
Candesartan Cilexetil 16mg, once a day for 8 weeks
Arm Title
Amlodipine(AML) 5mg
Arm Type
Experimental
Arm Description
Amlodipine 5mg, once a day for 8 weeks
Arm Title
AML 10mg
Arm Type
Experimental
Arm Description
Amlodipine 10mg, once a day for 8 weeks
Arm Title
CC 8mg / AML 5mg
Arm Type
Experimental
Arm Description
Candesartan 8mg and Amlodipine 5mg, once a day for 8 weeks
Arm Title
CC 8mg / AML 10mg
Arm Type
Experimental
Arm Description
Candesartan 8mg and Amlodipine 10mg, once a day for 8 weeks
Arm Title
CC 16mg / AML 5mg
Arm Type
Experimental
Arm Description
Candesartan 16mg and Amlodipine 5mg, once a day for 8 weeks
Arm Title
CC 16mg / AML 10mg
Arm Type
Experimental
Arm Description
Candesartan 16mg and Amlodipine 10mg, once a day for 8 weeks
Intervention Type
Drug
Intervention Name(s)
Candesartan Cilexetil 8mg
Other Intervention Name(s)
Atacand 8mg
Intervention Description
Candesartan Cilexetil 8mg Daily oral administration for 8 weeks
Intervention Type
Drug
Intervention Name(s)
Candesartan Cilexetil 16mg
Other Intervention Name(s)
Atacand 16mg
Intervention Description
Candesartan Cilexetil 16mg Daily oral administration for 8 weeks
Intervention Type
Drug
Intervention Name(s)
Amlodipine 5mg
Other Intervention Name(s)
Norvasc 5mg
Intervention Description
Amlodipine 5mg Daily oral administration for 8 weeks
Intervention Type
Drug
Intervention Name(s)
Amlodipine 10mg
Other Intervention Name(s)
Norvasc 10mg
Intervention Description
Amlodipine 10mg Daily oral administration for 8 weeks
Primary Outcome Measure Information:
Title
Change mean sitting Diastolic Blood Pressure (msDBP) at week 8 compared to baseline
Time Frame
Week 8
Secondary Outcome Measure Information:
Title
Change mean sitting Diastolic Blood Pressure (msDBP) at week 4 compared to baseline
Time Frame
Week 4
Title
Change mean sitting Systolic Blood Pressure (msSBP) at week 4 and 8 compared to baseline
Time Frame
Week 4 and 8
Title
Proportion of patients achieving treatment goal at week 4 and 8: < 140/90 mmHg
Description
Joint National Committee VII Guideline Treatment goal: < 140/90 mmHg (< 130/80 mmHg, diabetic or chronic renal failure patient)
Time Frame
Week 4 and 8
Title
Blood Pressure Response rate at week 4 and 8: msSBP reduction ≥ 20 mmHg and msDBP reduction ≥ 10 mmHg
Time Frame
Week 4 and 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients greater than or equal to 19 years of age Subject who was diagnosed with essential hypertension or after administer the antihypertensive drug (Subject who may temporarily suspend antihypertensive treatment based on doctor's decision) Subject who have voluntarily agreed to participate in the trial and signed the written informed consent form Exclusion Criteria: Subject with severe hypertension (in a selected arm with msSBP ≥ 200 mmHg or msDBP ≥ 115 mmHg) during the Screening and Randomized Trial. Subject with difference of the blood pressure of over 20 mmHg for SBP or 10 mmHg for diastolic blood pressure (DSP) between three consecutive measurements in a selected arm during the screening visit Secondary hypertension (such as, coarctation of the aorta, primary hyperaldosteronism, renal artery stenosis, Cushing's disease, pheochromocytoma, polycystic kidney disease, etc.) Symptomatic orthostatic hypotension Severe heart failure( New York Heart Association(NYHA) Class III/IV) Subject with acute coronary syndrome(myocardial infarction or unstable angina), peripheral vascular disease within the past 6 months History of switching to another Antiarrhythmic drugs(not including electrolyte correction), or received Cardioversion or ICU treatment within the past 6 months Type 1 diabetes mellitus or Uncontrolled Type 2 diabetes mellitus (HbA1c > 9.0%) Subject with Haemodynamic disturbance, heart valve disease with structural defects Severe cerebrovascular disease (stroke, cerebral infarction, or cerebral hemorrhage, etc. within the past 6 months) Severe eye disease (retinal hemorrhage, visual impairment, retinal microaneurysm, etc. within the past 6 months) Autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, etc.) Chronic inflammatory disease requiring continuous anti-inflammatory treatment Clinically significant Renal or liver impairment, or laboratory abnormalities such as Ccr: below 30ml/min or Aspartate Aminotransferase (AST) or Alanine Aminotransferase (ALT) > 3 x Upper Limit Normal (ULN) Hypokalaemia(Serum potassium < 3.5 mmol/L) or hyperkalaemia(Serum potassium > 5.5 mmol/L) Subject with gastrointestinal disease(such as Crohn's disease, gastric ulcer, acute or chronic pancreatitis) or history of gastrointestinal surgery(not including appendectomy or hernia surgery) that might significantly alter the absorption of the drug history of allergy or hypersensitivity to Angiotensin II Receptor Blockers(Candesartan) or Calcium Channel Blocker(amlodipine) Subject with heredity defects such as galactose intolerance, Lapp lactose deficiency, or glucose-galactose malabsorption Subject requiring concomitant use of other antihypertensive or contraindicated drugs( Tizanidine, dolasetron, Itraconazole, potassium, potassium-sparing diuretics, etc.) during the clinical trial history of malignant tumors within the past 5 years history of alcohol or drug abuse Pregnant women and lactating mothers Women who is planning to be pregnant during or 2 months after the study, or women or men who are not using medically acceptable methods of contraception * * progestin oral or implant contraceptive, intra-uterine device, condom, partner with surgical sterilization, etc. Use of other investigational products within the past 1 month Subject who are judged by the investigator unsuitable to participate in the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chong-Jin Kim
Organizational Affiliation
KyungHee University Hospital at Gangdong
Official's Role
Study Director
Facility Information:
Facility Name
Catholic University of Korea Bucheon St. Mary's Hospital
City
Wonmi-gu
State/Province
Bucheon
Country
Korea, Republic of
Facility Name
Inje University Busan Paik Hospital
City
Busanjin-gu
State/Province
Busan
Country
Korea, Republic of
Facility Name
Pusan National University Hospital
City
Seo-gu
State/Province
Busan
Country
Korea, Republic of
Facility Name
Keimyung University Dongsan Medical Center
City
Joong-gu
State/Province
Daegu
Country
Korea, Republic of
Facility Name
Kyungpook National University Hospital
City
Joong-gu
State/Province
Daegu
Country
Korea, Republic of
Facility Name
Daegu Catholic University Medical Center
City
Nam- gu
State/Province
Daegu
Country
Korea, Republic of
Facility Name
Dongguk University Ilsan Hospital
City
Ilsandong-gu
State/Province
Goyang-si, Gyeoggi-do
Country
Korea, Republic of
Facility Name
Chonnam National University Hospital
City
Dong-Gu
State/Province
Gwangju
Country
Korea, Republic of
Facility Name
Catholic University of Korea Uijeongbu St. Mary's hospital
City
Uijeongbu-si
State/Province
Gyeoggi-do
Country
Korea, Republic of
Facility Name
Gachon University Gil Hospital
City
Namdong-gu
State/Province
Incheon
Country
Korea, Republic of
Facility Name
St. Carollo General Hospital
City
Suncheon-si
State/Province
Jeollanam-do
Country
Korea, Republic of
Facility Name
Wonju Severance Christian Hospital
City
Wonju
State/Province
Kangwon-Do
Country
Korea, Republic of
Facility Name
Catholic University of Korea St. Paul's Hospital
City
Dongdaemun-gu
State/Province
Seoul
Country
Korea, Republic of
Facility Name
KyungHee University Medical Center
City
Dongdaemun-gu
State/Province
Seoul
Country
Korea, Republic of
Facility Name
Hallym University Kangdong Sacred Heart Hospital
City
Gangdong-gu
State/Province
Seoul
Country
Korea, Republic of
Facility Name
Kyung Hee University Hospital at Gangdong
City
Gangdong-Gu
State/Province
Seoul
Country
Korea, Republic of
Facility Name
VHS( Veterans Medical Service) Medical Center
City
Gangdong-gu
State/Province
Seoul
Country
Korea, Republic of
Facility Name
Konkuk University Medical Center
City
Gwangjin-gu
State/Province
Seoul
Country
Korea, Republic of
Facility Name
Seoul National University Hospital
City
Jongro-gu
State/Province
Seoul
Country
Korea, Republic of
Facility Name
Catholic University of Korea Seoul St. Mary's Hospital
City
Seocho-Gu
State/Province
Seoul
Country
Korea, Republic of
Facility Name
Korea University Anam Hospital
City
Seongbuk-Gu
State/Province
Seoul
Country
Korea, Republic of
Facility Name
Catholic University of Korea Yeouido St. Mary's Hospital
City
Yeongdeungpo-gu
State/Province
Seoul
Country
Korea, Republic of
Facility Name
Ulsan University Hospital
City
Dong-gu
State/Province
Ulsan
Country
Korea, Republic of

12. IPD Sharing Statement

Citations:
PubMed Identifier
28734660
Citation
Sohn IS, Kim CJ, Ahn T, Youn HJ, Jeon HK, Ihm SH, Cho EJ, Chung WB, Chae SC, Kim WS, Nam CW, Park SM, Choi JY, Kim YK, Hong TJ, Lee HY, Cho JH, Shin ES, Yoon JH, Yang TH, Jeong MH, Lee JH, Park JI. Efficacy and Tolerability of Combination Therapy Versus Monotherapy with Candesartan and/or Amlodipine for Dose Finding in Essential Hypertension: A Phase II Multicenter, Randomized, Double-blind Clinical Trial. Clin Ther. 2017 Aug;39(8):1628-1638. doi: 10.1016/j.clinthera.2017.06.014. Epub 2017 Jul 19.
Results Reference
derived

Learn more about this trial

Comparison of Efficacy and Safety of Combination Therapy and Monotherapy of Candesartan and Amlodipine for Dose-Finding in Patients With Essential Hypertension

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