search
Back to results

Novel Evaluation With QGC001 in Hypertensive Overweight Patients of Multiple Ethnic Origins (NEW-HOPE)

Primary Purpose

Hypertension

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
QGC001
Sponsored by
Quantum Genomics SA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypertension

Eligibility Criteria

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

Inclusion Criteria:

  • Subject must provide signed written informed consent;
  • Men and women greater than or equal to 18 years of age at Screening;
  • Diagnosis of primary (essential) hypertension (HTN) for at least 3 months prior to Screening and have an office SBP:

    • Between 145 mmHg and 170 mmHg at Screening and are treatment-naïve; or
    • Between 130 mmHg and 150 mmHg at Screening and are treated with less than or equal to 2 anti hypertensive medications. Anti-hypertensive medications must be stable for greater than or equal to 8 weeks prior to Screening;
  • SBP between 145 mmHg and 170 mmHg, inclusive, and DBP less than or equal to 105 mmHg at the Inclusion Visit after 2-week Run In Period;
  • Body mass index between 25 kg/m2 and 45 kg/m2 with the ability to fit the ambulatory blood pressure monitoring (ABPM) cuff per the manufacturer;
  • Subject must have a successful ABPM measurement prior to receiving the study drug.
  • Women of childbearing potential and non-surgically sterile male subjects who are sexually active must agree to use an approved highly effective form of contraception from the time of informed consent until 30 days post-dose.
  • Women of childbearing potential must have a negative serum pregnancy test result at Screening and a negative urine pregnancy test result at the Inclusion Visit (Day 0).

Exclusion Criteria:

  • Known or suspected secondary HTN (eg, renal artery stenosis, pheochromocytoma, Cushing's disease);
  • Office SBP greater than or equal to 171 mmHg and/or office diastolic blood pressure (DBP) greater than or equal to 105 mmHg at the Inclusion Visit (Day 0) and confirmed by a second measurement (not on the same day), preferably within 1 day;
  • Known hypertensive retinopathy (Keith-Wagener Grade 3 or Grade 4) and/or hypertensive encephalopathy;
  • History of spontaneous or drug-induced angioedema;
  • Clinically significant valvular heart disease or severe aortic stenosis;
  • Subjects with symptomatic heart failure (New York Heart Association Class II to Class IV);
  • History of acute coronary syndrome (non-ST elevation myocardial infarction, ST elevation myocardial infarction, and unstable angina pectoris), stroke, or transient ischemic attack within 6 months prior to Screening;
  • Known history of malabsorption syndrome, or has undergone gastrointestinal surgery, including bariatric procedures, that induce chronic malabsorption, within 2 years of Screening;
  • Treatment with anti-obesity drugs or procedures 3 months prior to Screening (ie, surgery, aggressive diet regimen, etc.), leading to unstable body weight;
  • Female who is breast feeding, pregnant, or planning to become pregnant during the study period;
  • Medical history of cancer (except for basal cell carcinoma) and/or treatment for cancer within the last 5 years;
  • Subject with an upper arm circumference that exceeds the upper circumference level (48.3 cm) of the cuff size of either the ABPM and/or office BP (OBP) measurement device used in the study;
  • Night shift workers who routinely sleep during the daytime and/or whose work hours include midnight;
  • Alanine aminotransferase, aspartate aminotransferase, or alkaline phosphatase >3 x upper limit of normal (ULN) or a total bilirubin greater than or equal to 2 x ULN (unless secondary to Gilbert's syndrome) at Screening or the Inclusion Visit (Day 0);
  • Estimated glomerular filtration rate <45mL/min/1.73m2, as calculated using the Chronic Kidney Disease Epidemiology Collaboration formula at Screening or the Inclusion Visit (Day 0);
  • History of any blood disorder, other than sickle cell trait, causing hemolysis or unstable red blood cells (eg, malaria, babesiosis, hemolytic anemia, thalassemia, sickle cell anemia);
  • Subjects with type 1 diabetes mellitus;
  • Subjects with type 2 diabetes mellitus who:

    • Are poorly controlled, defined as hemoglobin A1c >8% at Screening; or
    • Are taking short-acting insulin or sodium-glucose co transporter 2 inhibitors. Use of a stable dose (greater than or equal to 12 weeks prior to Screening) of medications listed in Appendix C is permitted;
  • Routine or anticipated treatment with all systemic corticosteroids. Use of topical, inhaled, or nasal corticosteroids is permitted;
  • Clinical evidence of thyroid disease, thyroid hormone therapy that is not stable greater than or equal to 4 weeks prior to Screening, or subjects with the following thyroid-stimulating hormone (TSH) levels at Screening:

    • For subjects on replacement therapy: TSH 0.75 to 1.5 x ULN; or
    • For subjects not on replacement therapy: TSH >1.5 x ULN;
  • History of alcohol or drug abuse within the 3 months prior to Screening that would interfere with study participation or lead to decreased compliance to study procedures or study drug intake in the Investigator's opinion;
  • Participation in another clinical study involving an investigational drug within 30 days prior to Screening, or plans to participate in another clinical study within 30 days of discontinuation of study drug;
  • Any condition, in the opinion of the Investigator, that would interfere with study participation, may pose a risk to the subject, or would make study participation not in the best interest of the subject;
  • Subjects with a life expectancy of less than 1 year per Investigator's discretion; or
  • Any subject who, in the opinion of the Investigator, will not be able to follow the protocol.

Sites / Locations

  • Progressive Medical Research

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

QGC001

Arm Description

Capsules of QGC001 250 mg

Outcomes

Primary Outcome Measures

Change in office systolic blood pressure from baseline to Week 8 (Day 56 Visit)
Office blood pressure will be taken at Day 0, Visit 3, Visit 4, Visit 4.1, and Visit 5 (Day 56).

Secondary Outcome Measures

Change in office diastolic blood pressure from baseline to Week 8 (Day 56 Visit)
Office blood pressure will be taken at Day 0, Visit 3, Visit 4, Visit 4.1, and Visit 5 (Day 56).
Change in office systolic blood pressure and diastolic blood pressure from baseline to Week 4 (Day 28 Visit)
Office blood pressure will be taken at Day 0, Visit 3, Visit 4, Visit 4.1, and Visit 5 (Day 56).
Change in mean 24-hour ambulatory systolic blood pressure, diastolic blood pressure, and mean office blood pressure from baseline to Week 8 (Day 56 Visit)
Ambulatory blood pressure monitoring will be performed at Day 0 and Day 56.
Percentage of responders (defined as subjects with normalized office blood pressure, ie, less than or equal to 140-90 mmHg at Week 8 - Day 56 Visit)
Frequency and percentage of subjects who reach the level by the Week 8 (Day 56 Visit).
Predictive factors for responders at Week 8 (Day 56 Visit)
Identification of potential factors for responders, including baseline systolic blood pressure and diastolic blood pressure, gender, age, BMI, and others.

Full Information

First Posted
June 16, 2017
Last Updated
December 10, 2018
Sponsor
Quantum Genomics SA
search

1. Study Identification

Unique Protocol Identification Number
NCT03198793
Brief Title
Novel Evaluation With QGC001 in Hypertensive Overweight Patients of Multiple Ethnic Origins
Acronym
NEW-HOPE
Official Title
A Phase 2, Open-Label, Dose-Titrating Safety and Efficacy Study of QGC001 Administered Orally, Twice Daily, Over 8 Weeks in Hypertensive Overweight Subjects of Multiple Ethnic and Racial Groups in the United States
Study Type
Interventional

2. Study Status

Record Verification Date
December 2018
Overall Recruitment Status
Completed
Study Start Date
October 13, 2017 (Actual)
Primary Completion Date
October 16, 2018 (Actual)
Study Completion Date
November 12, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Quantum Genomics SA

4. Oversight

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

5. Study Description

Brief Summary
Essential hypertension (HTN) is a disease that affects approximately 1 billion individuals worldwide. Despite the availability of effective and safe anti-hypertensive drugs, 65% of subjects diagnosed with HTN do not have their blood pressure (BP) controlled (<140/90 mmHg). The overall incidence of resistant HTN, (defined as requiring 3 or more anti-hypertensive drugs, including a diuretic, to control BP) is estimated to be 15% of the hypertensive population. Consequently, there is a pressing unmet medical need to develop new classes of anti-hypertensive drugs that act on alternative pathways and further control BP and the associated cardiovascular risks in subjects. The prevalence of HTN in African Americans in the United States is among the highest in the world, and HTN is more common in African Americans than in Caucasians. One of the risk factors for HTN is sodium sensitivity. There is a higher association of HTN with sodium sensitivity in African American subjects and other racial/ethnic groups who are overweight/obese. Effective agents to treat HTN in this high-risk population are clearly needed. This study will be conducted in a hypertensive, overweight subject population of multiple ethnic origins in which QGC001 is likely, based on its mode of action, to demonstrate a significant anti-hypertensive effect.
Detailed Description
QGC001 is a prodrug of the specific and selective APA inhibitor, EC33, and is the prototype of a new class of centrally-acting anti-hypertensive agents called brain APA inhibitors. Inhibition of brain APA, which converts Ang II into Ang III, has emerged as a novel anti hypertensive treatment, as demonstrated in several experimental animal models. QGC001's anti-hypertensive effect is in part due to: 1) a decrease in arginine vasopressin release in the blood circulation, increasing diuresis, which reduces the size of body fluid compartment; and 2) a reduction in the sympathetic tone, leading to subsequent decreases in vascular resistances. This study is an open-label, dose-titrating safety and efficacy study of QGC001 administered PO, BID, over 8 weeks in hypertensive overweight subjects of multiple ethnic and racial groups in the United States. The primary objective of this study is to assess the effects of twice daily (BID) administration of oral (PO) QGC001 (250 mg BID, 500 mg BID, and 500 mg BID + hydrochlorothiazide (HCTZ) 25 mg once daily [QD]) on blood pressure (BP) over 8 weeks in hypertensive overweight/obese subjects of multiple races/ethnicities.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertension

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
256 (Actual)

8. Arms, Groups, and Interventions

Arm Title
QGC001
Arm Type
Experimental
Arm Description
Capsules of QGC001 250 mg
Intervention Type
Drug
Intervention Name(s)
QGC001
Intervention Description
Twice daily (BID) administration of oral (PO) QGC001 (250 mg BID, 500 mg BID, and 500 mg BID + hydrochlorothiazide (HCTZ) 25 mg once daily [QD]) over 8 weeks.
Primary Outcome Measure Information:
Title
Change in office systolic blood pressure from baseline to Week 8 (Day 56 Visit)
Description
Office blood pressure will be taken at Day 0, Visit 3, Visit 4, Visit 4.1, and Visit 5 (Day 56).
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Change in office diastolic blood pressure from baseline to Week 8 (Day 56 Visit)
Description
Office blood pressure will be taken at Day 0, Visit 3, Visit 4, Visit 4.1, and Visit 5 (Day 56).
Time Frame
8 weeks
Title
Change in office systolic blood pressure and diastolic blood pressure from baseline to Week 4 (Day 28 Visit)
Description
Office blood pressure will be taken at Day 0, Visit 3, Visit 4, Visit 4.1, and Visit 5 (Day 56).
Time Frame
4 weeks
Title
Change in mean 24-hour ambulatory systolic blood pressure, diastolic blood pressure, and mean office blood pressure from baseline to Week 8 (Day 56 Visit)
Description
Ambulatory blood pressure monitoring will be performed at Day 0 and Day 56.
Time Frame
8 weeks
Title
Percentage of responders (defined as subjects with normalized office blood pressure, ie, less than or equal to 140-90 mmHg at Week 8 - Day 56 Visit)
Description
Frequency and percentage of subjects who reach the level by the Week 8 (Day 56 Visit).
Time Frame
8 weeks
Title
Predictive factors for responders at Week 8 (Day 56 Visit)
Description
Identification of potential factors for responders, including baseline systolic blood pressure and diastolic blood pressure, gender, age, BMI, and others.
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject must provide signed written informed consent; Men and women greater than or equal to 18 years of age at Screening; Diagnosis of primary (essential) hypertension (HTN) for at least 3 months prior to Screening and have an office SBP: Between 145 mmHg and 170 mmHg at Screening and are treatment-naïve; or Between 130 mmHg and 150 mmHg at Screening and are treated with less than or equal to 2 anti hypertensive medications. Anti-hypertensive medications must be stable for greater than or equal to 8 weeks prior to Screening; SBP between 145 mmHg and 170 mmHg, inclusive, and DBP less than or equal to 105 mmHg at the Inclusion Visit after 2-week Run In Period; Body mass index between 25 kg/m2 and 45 kg/m2 with the ability to fit the ambulatory blood pressure monitoring (ABPM) cuff per the manufacturer; Subject must have a successful ABPM measurement prior to receiving the study drug. Women of childbearing potential and non-surgically sterile male subjects who are sexually active must agree to use an approved highly effective form of contraception from the time of informed consent until 30 days post-dose. Women of childbearing potential must have a negative serum pregnancy test result at Screening and a negative urine pregnancy test result at the Inclusion Visit (Day 0). Exclusion Criteria: Known or suspected secondary HTN (eg, renal artery stenosis, pheochromocytoma, Cushing's disease); Office SBP greater than or equal to 171 mmHg and/or office diastolic blood pressure (DBP) greater than or equal to 105 mmHg at the Inclusion Visit (Day 0) and confirmed by a second measurement (not on the same day), preferably within 1 day; Known hypertensive retinopathy (Keith-Wagener Grade 3 or Grade 4) and/or hypertensive encephalopathy; History of spontaneous or drug-induced angioedema; Clinically significant valvular heart disease or severe aortic stenosis; Subjects with symptomatic heart failure (New York Heart Association Class II to Class IV); History of acute coronary syndrome (non-ST elevation myocardial infarction, ST elevation myocardial infarction, and unstable angina pectoris), stroke, or transient ischemic attack within 6 months prior to Screening; Known history of malabsorption syndrome, or has undergone gastrointestinal surgery, including bariatric procedures, that induce chronic malabsorption, within 2 years of Screening; Treatment with anti-obesity drugs or procedures 3 months prior to Screening (ie, surgery, aggressive diet regimen, etc.), leading to unstable body weight; Female who is breast feeding, pregnant, or planning to become pregnant during the study period; Medical history of cancer (except for basal cell carcinoma) and/or treatment for cancer within the last 5 years; Subject with an upper arm circumference that exceeds the upper circumference level (48.3 cm) of the cuff size of either the ABPM and/or office BP (OBP) measurement device used in the study; Night shift workers who routinely sleep during the daytime and/or whose work hours include midnight; Alanine aminotransferase, aspartate aminotransferase, or alkaline phosphatase >3 x upper limit of normal (ULN) or a total bilirubin greater than or equal to 2 x ULN (unless secondary to Gilbert's syndrome) at Screening or the Inclusion Visit (Day 0); Estimated glomerular filtration rate <45mL/min/1.73m2, as calculated using the Chronic Kidney Disease Epidemiology Collaboration formula at Screening or the Inclusion Visit (Day 0); History of any blood disorder, other than sickle cell trait, causing hemolysis or unstable red blood cells (eg, malaria, babesiosis, hemolytic anemia, thalassemia, sickle cell anemia); Subjects with type 1 diabetes mellitus; Subjects with type 2 diabetes mellitus who: Are poorly controlled, defined as hemoglobin A1c >8% at Screening; or Are taking short-acting insulin or sodium-glucose co transporter 2 inhibitors. Use of a stable dose (greater than or equal to 12 weeks prior to Screening) of medications listed in Appendix C is permitted; Routine or anticipated treatment with all systemic corticosteroids. Use of topical, inhaled, or nasal corticosteroids is permitted; Clinical evidence of thyroid disease, thyroid hormone therapy that is not stable greater than or equal to 4 weeks prior to Screening, or subjects with the following thyroid-stimulating hormone (TSH) levels at Screening: For subjects on replacement therapy: TSH 0.75 to 1.5 x ULN; or For subjects not on replacement therapy: TSH >1.5 x ULN; History of alcohol or drug abuse within the 3 months prior to Screening that would interfere with study participation or lead to decreased compliance to study procedures or study drug intake in the Investigator's opinion; Participation in another clinical study involving an investigational drug within 30 days prior to Screening, or plans to participate in another clinical study within 30 days of discontinuation of study drug; Any condition, in the opinion of the Investigator, that would interfere with study participation, may pose a risk to the subject, or would make study participation not in the best interest of the subject; Subjects with a life expectancy of less than 1 year per Investigator's discretion; or Any subject who, in the opinion of the Investigator, will not be able to follow the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Keith C. Ferdinand, MD FACC
Organizational Affiliation
Tulane University SOM, New Orleans, LA 70112
Official's Role
Study Chair
Facility Information:
Facility Name
Progressive Medical Research
City
Port Orange
State/Province
Florida
ZIP/Postal Code
32127
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33027067
Citation
Khosla J, Aronow WS, Frishman WH. Firibastat: An Oral First-in-Class Brain Aminopeptidase A Inhibitor for Systemic Hypertension. Cardiol Rev. 2022 Jan-Feb 01;30(1):50-55. doi: 10.1097/CRD.0000000000000360.
Results Reference
derived
PubMed Identifier
31923435
Citation
Ferdinand KC, Harrison D, Johnson A. The NEW-HOPE study and emerging therapies for difficult-to-control and resistant hypertension. Prog Cardiovasc Dis. 2020 Jan-Feb;63(1):64-73. doi: 10.1016/j.pcad.2019.12.008. Epub 2020 Jan 8.
Results Reference
derived
PubMed Identifier
31014072
Citation
Ferdinand KC, Balavoine F, Besse B, Black HR, Desbrandes S, Dittrich HC, Nesbitt SD. Efficacy and Safety of Firibastat, A First-in-Class Brain Aminopeptidase A Inhibitor, in Hypertensive Overweight Patients of Multiple Ethnic Origins. Circulation. 2019 Jul 9;140(2):138-146. doi: 10.1161/CIRCULATIONAHA.119.040070. Epub 2019 Apr 24.
Results Reference
derived

Learn more about this trial

Novel Evaluation With QGC001 in Hypertensive Overweight Patients of Multiple Ethnic Origins

We'll reach out to this number within 24 hrs