Azilsartan Medoxomil in the Treatment of Essential Hypertension and Type 2 Diabetes in Asia
Primary Purpose
Essential Hypertension, Type 2 Diabetes Mellitus
Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Azilsartan Medoxomil
Sponsored by
About this trial
This is an interventional treatment trial for Essential Hypertension focused on measuring Drug therapy
Eligibility Criteria
Inclusion Criteria:
- In the opinion of the investigator, the participant is capable of understanding and complying with protocol requirements.
- The participant or, when applicable, the participant's legally acceptable representative signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures.
- Has type 2 diabetes mellitus (T2DM) with essential hypertension.
- T2DM participants are either treated by stable life style intervention or by oral antidiabetic drugs (OADs) that are stable, including no dose adjustment within 12 weeks before baseline.
- Is male or female and aged 18 to 75 years, inclusive.
- Uncontrolled hypertension (systolic blood pressure ≥140 mmHg to <180 mmHg, or diastolic blood pressure ≥85 mmHg and <110 mmHg at screening and baseline.
- Has screening glycosylated hemoglobin (HbA1C) <9.5%.
- Female participants must be either of non-childbearing potential, ie, surgically sterilized (defined as having undergone hysterectomy and/or bilateral oophorectomy and/or bilateral salpingectomy; tubal ligation alone is not considered sufficient) or one year after the last menstrual period; or, if of childbearing potential and participant is sexually active with a nonsterilized male partner, must agree to use routinely adequate contraception from signing of informed consent throughout the duration of study.
Exclusion Criteria:
- Has systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg despite concurrent treatment with three antihypertensive medications from different classes at adequate doses including a diuretic.
- Has type 1 or poorly controlled type 2 diabetes mellitus, defined as HbA1c ≥9.5% at screening.
- Is treated with OADs has not been on stable treatment including no dose change of their OADs for at least 12 weeks prior to baseline.
- Has been previously treated with azilsartan medoxomil (AZM) or azilsartan.
- Has secondary hypertension of any etiology (eg, renovascular disease, pheochromocytoma, Cushing's syndrome).
- Has congestive heart failure (New York Heart Association class III or IV), clinically relevant cardiac arrhythmias (as determined by the investigator's clinical judgment on a participant-by-participant basis), severe obstructive coronary artery disease.
- Has participated in a clinical trial including interventional and observational studies, or received any investigational compound currently or 30 days prior to screening.
- Has severe renal impairment (based on estimated glomerular filtration rate [GFR] <30 mL/min/1.73m^2) at Screening.
- Has hyperkalemia defined as serum potassium >5.0 mEq/L.
- Has an alanine aminotransferase (ALT) level of greater than 2.5 times the upper limit of normal, active liver disease, or jaundice at screening.
- Has any clinically relevant disease (eg malignancy, neurological, hepatic abnormalities) and/or significant abnormal laboratory findings (past or present), which, in the opinion of the investigator, may put the participant at risk because of participation in the study.
- Is taking prohibited medications including lithium and aliskiren (refer to Edarbi® product insert).
- Has known hypersensitivity to any excipients or angiotensin converting enzyme inhibitor (ACEIs)/ angiotensin receptor blockers (ARBs).
- Has prior angioedema due to an ACE inhibitor or ARB.
- Breast feeding or pregnant women or women who are intending to become pregnant before, during or within 1 month after participating in the study; or intending to donate ova during such time period, or refusal to submit to a urine test to rule out pregnancy prior to enrolment and at end of study.
- Have a history of alcohol abuse, drug abuse or illegal drug addiction within the 6 months prior to signing the informed consent.
- Is an immediate family member, study site employee, or is in a dependent relationship with a study site employee who is involved in conduct of this study (eg, spouse, parent, child, sibling) or may consent under duress.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Azilsartan medoxomil
Arm Description
Azilsartan medoxomil 40 mg, tablets, orally, once, daily, for 12 weeks. Azilsartan medoxomil dose may be increased to 80 mg once daily if blood pressure has not reach BP goal of <140/85 mmHg at Week 6.
Outcomes
Primary Outcome Measures
Percentage of Participants With Blood Pressure (BP) <140/85 mmHg (Systolic BP <140 mmHg and Diastolic BP <85 mmHg) by Clinic-Measured Sitting BP at Week 12
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Secondary Outcome Measures
Percentage of "Treatment-Naïve" Participants Reaching BP <140/85 mmHg
Treatment-naïve participants are defined as participants who have not received anti-hypertensive treatment for at least four weeks prior to screening. At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants Treated With Calcium Channel Blocker (CCB) Before Baseline Reaching BP<140/85 mmHg
At each visit three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants Treated With Angiotensin Converting Enzyme (ACE) Inhibitors or Other Angiotensin Receptor Blockers (ARBs) Before Baseline Reaching BP <140/85 mmHg
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants Treated With Thiazides Before Baseline Reaching BP <140/85 mmHg
At each visit three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of "Treatment-Naïve" Participants Reaching BP <130/80 mmHg
Treatment-naïve participants are defined as participants who have not received anti-hypertensive treatment for at least four weeks prior to screening. At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants Treated With CCB Before Baseline Reaching BP <130/80 mmHg
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants Treated With ACE Inhibitors or Other ARBs Before Baseline Reaching BP <130/80 mmHg
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants Treated With Thiazides Before Baseline Reaching BP <130/80 mmHg
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants With Systolic Blood Pressure (SBP) <140 mmHg at Week 12
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants With Diastolic Blood Pressure (DBP) <85 mmHg at Week 12
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants With DBP <90 mmHg at Week 12
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants With BP <130/80 mmHg at Week 12
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants With SBP <130 mmHg at Week 12
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants With DBP <80 mmHg at Week 12
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Percentage of Participants With BP <140/90 mmHg at Week 12
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Change From Baseline in Trough Sitting SBP at Week 12
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer. Change from Baseline was estimated using an ANCOVA model with fixed effects, country, baseline hypertension therapy (BHT) and baseline SBP (or DBP) included as a covariate. A negative change from baseline indicates improvement.
Change From Baseline in Trough Sitting SBP at Week 12 in "Treatment-Naïve" Participants
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer. Change from Baseline was estimated using an ANCOVA model with fixed effects, country, baseline hypertension therapy (BHT) and baseline SBP (or DBP) included as a covariate. A negative change from baseline indicates improvement.
Change From Baseline in DBP at Week 12
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer. Change from Baseline was estimated using an ANCOVA model with fixed effects, country, BHT and baseline SBP (or DBP) included as a covariate. A negative change from baseline indicates improvement.
Change From Baseline in DBP at Week 12 in "Treatment-Naïve" Participants
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer. Change from Baseline was estimated using an ANCOVA model with fixed effects, country, BHT and baseline SBP (or DBP) included as a covariate. A negative change from baseline indicates improvement.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02517866
Brief Title
Azilsartan Medoxomil in the Treatment of Essential Hypertension and Type 2 Diabetes in Asia
Official Title
A Prospective Study of Azilsartan Medoxomil in the Treatment of Patients With Essential Hypertension and Type 2 Diabetes in Asia
Study Type
Interventional
2. Study Status
Record Verification Date
October 2018
Overall Recruitment Status
Completed
Study Start Date
July 13, 2015 (Actual)
Primary Completion Date
November 15, 2016 (Actual)
Study Completion Date
November 25, 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Takeda
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
The purpose of this study is to evaluate the efficacy and safety of azilsartan medoxomil (AZM) in Asian adult participants with both essential hypertension and type 2 diabetes.
Detailed Description
The drug being tested in this study is called azilsartan medoxomil. Azilsartan medoxomil is being tested to treat people who have essential hypertension and type 2 diabetes mellitus (T2DM). This study will look at the blood pressure of people who take azilsartan medoxomil in addition to standard care for T2DM.
The study will enroll approximately 380 patients. All participants will receive azilsartan medoxomil 40 mg tablets to be administered orally, once a day, for 12 weeks. If a participant's blood pressure (BP) has not reached BP goal of <140/85 mmHg at week 6, azilsartan medoxomil dose will be up-titrated to 80 mg daily.
All participants will be asked to take one tablet at the same time each day throughout the study.
This multi-center trial will be conducted in Asia. The overall time to participate in this study is 14 weeks. Participants will make multiple visits to the clinic, and will be contacted by 14 days after last dose of study drug for a follow-up assessment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Essential Hypertension, Type 2 Diabetes Mellitus
Keywords
Drug therapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
380 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Azilsartan medoxomil
Arm Type
Experimental
Arm Description
Azilsartan medoxomil 40 mg, tablets, orally, once, daily, for 12 weeks. Azilsartan medoxomil dose may be increased to 80 mg once daily if blood pressure has not reach BP goal of <140/85 mmHg at Week 6.
Intervention Type
Drug
Intervention Name(s)
Azilsartan Medoxomil
Other Intervention Name(s)
Edarbi®
Intervention Description
Azilsartan medoxomil tablets
Primary Outcome Measure Information:
Title
Percentage of Participants With Blood Pressure (BP) <140/85 mmHg (Systolic BP <140 mmHg and Diastolic BP <85 mmHg) by Clinic-Measured Sitting BP at Week 12
Description
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Week 12
Secondary Outcome Measure Information:
Title
Percentage of "Treatment-Naïve" Participants Reaching BP <140/85 mmHg
Description
Treatment-naïve participants are defined as participants who have not received anti-hypertensive treatment for at least four weeks prior to screening. At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Up to Week 12
Title
Percentage of Participants Treated With Calcium Channel Blocker (CCB) Before Baseline Reaching BP<140/85 mmHg
Description
At each visit three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Weeks 6 and 12
Title
Percentage of Participants Treated With Angiotensin Converting Enzyme (ACE) Inhibitors or Other Angiotensin Receptor Blockers (ARBs) Before Baseline Reaching BP <140/85 mmHg
Description
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Weeks 6 and 12
Title
Percentage of Participants Treated With Thiazides Before Baseline Reaching BP <140/85 mmHg
Description
At each visit three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Weeks 6 and 12
Title
Percentage of "Treatment-Naïve" Participants Reaching BP <130/80 mmHg
Description
Treatment-naïve participants are defined as participants who have not received anti-hypertensive treatment for at least four weeks prior to screening. At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Up to Week 12
Title
Percentage of Participants Treated With CCB Before Baseline Reaching BP <130/80 mmHg
Description
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Weeks 6 and 12
Title
Percentage of Participants Treated With ACE Inhibitors or Other ARBs Before Baseline Reaching BP <130/80 mmHg
Description
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Weeks 6 and 12
Title
Percentage of Participants Treated With Thiazides Before Baseline Reaching BP <130/80 mmHg
Description
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Weeks 6 and 12
Title
Percentage of Participants With Systolic Blood Pressure (SBP) <140 mmHg at Week 12
Description
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Week 12
Title
Percentage of Participants With Diastolic Blood Pressure (DBP) <85 mmHg at Week 12
Description
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Week 12
Title
Percentage of Participants With DBP <90 mmHg at Week 12
Description
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Week 12
Title
Percentage of Participants With BP <130/80 mmHg at Week 12
Description
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Week 12
Title
Percentage of Participants With SBP <130 mmHg at Week 12
Description
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Week 12
Title
Percentage of Participants With DBP <80 mmHg at Week 12
Description
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Week 12
Title
Percentage of Participants With BP <140/90 mmHg at Week 12
Description
Three serial BP measurements were determined while the participant was seated, with a sphygmomanometer.
Time Frame
Week 12
Title
Change From Baseline in Trough Sitting SBP at Week 12
Description
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer. Change from Baseline was estimated using an ANCOVA model with fixed effects, country, baseline hypertension therapy (BHT) and baseline SBP (or DBP) included as a covariate. A negative change from baseline indicates improvement.
Time Frame
Baseline and Week 12
Title
Change From Baseline in Trough Sitting SBP at Week 12 in "Treatment-Naïve" Participants
Description
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer. Change from Baseline was estimated using an ANCOVA model with fixed effects, country, baseline hypertension therapy (BHT) and baseline SBP (or DBP) included as a covariate. A negative change from baseline indicates improvement.
Time Frame
Baseline and Week 12
Title
Change From Baseline in DBP at Week 12
Description
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer. Change from Baseline was estimated using an ANCOVA model with fixed effects, country, BHT and baseline SBP (or DBP) included as a covariate. A negative change from baseline indicates improvement.
Time Frame
Baseline and Week 12
Title
Change From Baseline in DBP at Week 12 in "Treatment-Naïve" Participants
Description
At each visit 3 serial BP measurements were determined while the participant was seated, with a sphygmomanometer. Change from Baseline was estimated using an ANCOVA model with fixed effects, country, BHT and baseline SBP (or DBP) included as a covariate. A negative change from baseline indicates improvement.
Time Frame
Baseline and Week 12
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
In the opinion of the investigator, the participant is capable of understanding and complying with protocol requirements.
The participant or, when applicable, the participant's legally acceptable representative signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures.
Has type 2 diabetes mellitus (T2DM) with essential hypertension.
T2DM participants are either treated by stable life style intervention or by oral antidiabetic drugs (OADs) that are stable, including no dose adjustment within 12 weeks before baseline.
Is male or female and aged 18 to 75 years, inclusive.
Uncontrolled hypertension (systolic blood pressure ≥140 mmHg to <180 mmHg, or diastolic blood pressure ≥85 mmHg and <110 mmHg at screening and baseline.
Has screening glycosylated hemoglobin (HbA1C) <9.5%.
Female participants must be either of non-childbearing potential, ie, surgically sterilized (defined as having undergone hysterectomy and/or bilateral oophorectomy and/or bilateral salpingectomy; tubal ligation alone is not considered sufficient) or one year after the last menstrual period; or, if of childbearing potential and participant is sexually active with a nonsterilized male partner, must agree to use routinely adequate contraception from signing of informed consent throughout the duration of study.
Exclusion Criteria:
Has systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg despite concurrent treatment with three antihypertensive medications from different classes at adequate doses including a diuretic.
Has type 1 or poorly controlled type 2 diabetes mellitus, defined as HbA1c ≥9.5% at screening.
Is treated with OADs has not been on stable treatment including no dose change of their OADs for at least 12 weeks prior to baseline.
Has been previously treated with azilsartan medoxomil (AZM) or azilsartan.
Has secondary hypertension of any etiology (eg, renovascular disease, pheochromocytoma, Cushing's syndrome).
Has congestive heart failure (New York Heart Association class III or IV), clinically relevant cardiac arrhythmias (as determined by the investigator's clinical judgment on a participant-by-participant basis), severe obstructive coronary artery disease.
Has participated in a clinical trial including interventional and observational studies, or received any investigational compound currently or 30 days prior to screening.
Has severe renal impairment (based on estimated glomerular filtration rate [GFR] <30 mL/min/1.73m^2) at Screening.
Has hyperkalemia defined as serum potassium >5.0 mEq/L.
Has an alanine aminotransferase (ALT) level of greater than 2.5 times the upper limit of normal, active liver disease, or jaundice at screening.
Has any clinically relevant disease (eg malignancy, neurological, hepatic abnormalities) and/or significant abnormal laboratory findings (past or present), which, in the opinion of the investigator, may put the participant at risk because of participation in the study.
Is taking prohibited medications including lithium and aliskiren (refer to Edarbi® product insert).
Has known hypersensitivity to any excipients or angiotensin converting enzyme inhibitor (ACEIs)/ angiotensin receptor blockers (ARBs).
Has prior angioedema due to an ACE inhibitor or ARB.
Breast feeding or pregnant women or women who are intending to become pregnant before, during or within 1 month after participating in the study; or intending to donate ova during such time period, or refusal to submit to a urine test to rule out pregnancy prior to enrolment and at end of study.
Have a history of alcohol abuse, drug abuse or illegal drug addiction within the 6 months prior to signing the informed consent.
Is an immediate family member, study site employee, or is in a dependent relationship with a study site employee who is involved in conduct of this study (eg, spouse, parent, child, sibling) or may consent under duress.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director Clinical Science
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Hong Kong
State/Province
Hong Kong
Country
China
City
Changhua County
Country
Taiwan
City
Kaohsiung City
Country
Taiwan
City
Kaohsiung
Country
Taiwan
City
Taichung
Country
Taiwan
City
Tainan City
Country
Taiwan
City
Taipei
Country
Taiwan
City
Taoyuan County
Country
Taiwan
City
Bangkok
Country
Thailand
City
Chiang Mai
Country
Thailand
City
Khon Kaen
Country
Thailand
City
Pathumthani
Country
Thailand
12. IPD Sharing Statement
Learn more about this trial
Azilsartan Medoxomil in the Treatment of Essential Hypertension and Type 2 Diabetes in Asia
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