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Efficacy and Safety of Azilsartan in Subjects With Essential Hypertension

Primary Purpose

Hypertension

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Azilsartan
Azilsartan
Azilsartan
Azilsartan
Azilsartan
Placebo
Olmesartan
Sponsored by
Takeda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypertension focused on measuring Blood Pressure, Drug Therapy, Systolic Pressure, Diastolic Pressure, Vascular Diseases

Eligibility Criteria

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

Inclusion Criteria:

  • Has mild to moderate uncomplicated essential hypertension (diastolic blood pressure between 95 and 114 mm Hg at Screening Day -7 and randomization visit).
  • Female patients of childbearing potential must be nonpregnant and nonlactating, and utilizing an acceptable method of contraception.
  • Has clinical laboratory evaluations (including clinical chemistry, hematology, and complete urinalysis) within the reference range for the testing laboratory unless the results are deemed not clinically significant for inclusion into this study by the investigator or sponsor.
  • Is willing to discontinue current antihypertensive medications.

Exclusion Criteria:

  • Has a decrease of more than or equal to 8 mm Hg in clinic diastolic blood pressure between Screening Day -7 and randomization visit.
  • Is hypersensitive to angiotensin II receptor blockers.
  • The patient has Grade 3 or 4 hypertensive retinopathy (Keith-Wagener scale).
  • Has significant cardiac disease (eg, primary, hemodynamically significant cardiac valvular disease) other than mild to moderate uncomplicated hypertensive cardiovascular disease.
  • Has taken, within 7 days prior to placebo run-in, or is expected to take, medications known to affect blood pressure, including the following:

    • Diuretics
    • Anti-hypertensives
    • Vasodilators
    • Tricyclic antidepressants
    • Monoamine oxidase inhibitors
    • Phenothiazines
    • Diet medications
    • Amphetamines or their derivatives
    • Thiazolidinediones
    • Lithium
    • Chronic use of common cold medications or nonsteroidal anti-inflammatory drugs including aspirin >325 mg/day or cyclooxygenase-2 inhibitors).
  • Has a history of myocardial infarction complicated by heart failure, post-myocardial infarction angina, hypertensive encephalopathy, or cerebrovascular accident.
  • Has clinically significant cardiac conduction defects (eg, 2nd or 3rd degree atrioventricular block, left bundle branch block, sick sinus syndrome, atrial fibrillation or flutter).
  • Has secondary hypertension of any etiology (eg, renal disease, pheochromocytoma, Cushing's syndrome).
  • Has a history of collagen vascular disorder (eg systemic lupus erythematosus, scleroderma) within the last five years.
  • Has an upper arm circumference less than 24 or greater than 42 cm.
  • Works night (3rd) shift.
  • Is non-compliant (less than 80%) with study medication during placebo run-in period.
  • Has significant, moderate to severe renal dysfunction or disease (including renal artery stenosis).
  • Has a history of drug abuse (defined as illicit drug use) or a history of alcohol abuse (defined as regular or daily consumption of more than 4 alcoholic drinks per day) within the past 2 years.
  • Has a previous history of cancer, other than basal cell carcinoma, that has not been in remission for at least 5 years prior to the first dose of study drug.
  • Has Type I or Type II diabetes mellitus.
  • Has an alanine transaminase or aspartate transaminase level of greater than 3 times the upper limit of normal, active liver disease, or jaundice.
  • Is participating in another investigational study or has participated in an investigational study within 30 days prior to randomization.
  • Has -any other serious disease or condition at Screening (or randomization) that would compromise patient safety, might affect life expectancy, or make it difficult to successfully manage and follow the patient according to the protocol.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm 6

    Arm 7

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Placebo Comparator

    Active Comparator

    Arm Label

    Azilsartan 2.5 mg QD

    Azilsartan 5 mg QD

    Azilsartan 10 mg QD

    Azilsartan 20 mg QD

    Azilsartan 40 mg QD

    Placebo QD

    Olmesartan 20 mg QD

    Arm Description

    Outcomes

    Primary Outcome Measures

    Change from Baseline in sitting clinic diastolic blood pressure.

    Secondary Outcome Measures

    Change from Baseline in sitting clinic systolic blood pressure.
    The change from Baseline in standing clinic diastolic blood pressure and systolic blood pressure.
    Change from Baseline in diastolic blood pressure and systolic blood pressure as measured by ambulatory blood pressure monitoring.

    Full Information

    First Posted
    September 24, 2008
    Last Updated
    June 17, 2010
    Sponsor
    Takeda
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00759551
    Brief Title
    Efficacy and Safety of Azilsartan in Subjects With Essential Hypertension
    Official Title
    A Phase 2, Double-Blind, Randomized, Placebo-Controlled, Dose-Ranging Study of the Efficacy, Safety, and Tolerability of TAK-536 in Patients With Mild to Moderate Uncomplicated Essential Hypertension
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2010
    Overall Recruitment Status
    Completed
    Study Start Date
    August 2004 (undefined)
    Primary Completion Date
    June 2005 (Actual)
    Study Completion Date
    June 2005 (Actual)

    3. Sponsor/Collaborators

    Name of the Sponsor
    Takeda

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this study is to determine the safety and efficacy of azilsartan, once daily (QD), in subjects with essential hypertension.
    Detailed Description
    According to the National Health and Nutrition Examination Survey, approximately 60 million people in the United States are hypertensive. Although no single risk factor is responsible for the development of hypertension, some of the many risk factors can be controlled, and some cannot. Controllable risk factors include weight gain, smoking, a sedentary lifestyle, poor eating habits, emotional stress, physical tension, sodium sensitivity, alcohol abuse, and use of oral contraceptives. Uncontrollable risk factors include family history, gender, age and race. Hypertension is termed the "silent killer" because many patients are asymptomatic. Chronic hypertension causes extensive arterial wall damage, which allows cholesterol to adhere to the damaged endothelial lining and produces increased cardiac stress. Hypertension dramatically increases the risk of myocardial infarction, stroke, renal damage, impaired vision, heart failure and overall mortality. Angiotensin II receptor blockers are a class of drugs used for the treatment of hypertension that not only decrease blood pressure, but also likely contribute to protecting hypertensive individuals from cardiac events, strokes and loss of renal function. Angiotensin II has significant physiological effects on tissues and organs throughout the body including vascular smooth muscle, adrenal cortex, kidney, and brain. Angiotensin II receptors are located on the plasma membrane of target cells to facilitate the rapid onset of angiotensin II. Three distinct subtypes of angiotensin II receptors have been identified: angiotensin II type-1 receptor, angiotensin type 2, and angiotensin type 4; and the relative proportion of each vary from tissue to tissue. The angiotensin II type-1 receptor subtype is expressed predominantly in vascular smooth muscle cells where activation by angiotensin II results in vasoconstriction, cell proliferation, fibrosis, and cellular hypertrophy. In contrast, angiotensin II type-2 receptor stimulation produces pharmacologic activities that are opposite to those that occur after angiotensin II type-1 receptor stimulation. The angiotensin II type-4 receptor has been reported to be expressed in the adrenals, brain, and myocardium, but its exact function remains unknown. It is not considered to play an important role in human pathogenesis. TAK-536 (azilsartan) is a synthetic angiotensin II type-1 receptor antagonist being developed as a treatment for mild to moderate uncomplicated essential hypertension

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Hypertension
    Keywords
    Blood Pressure, Drug Therapy, Systolic Pressure, Diastolic Pressure, Vascular Diseases

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Azilsartan 2.5 mg QD
    Arm Type
    Experimental
    Arm Title
    Azilsartan 5 mg QD
    Arm Type
    Experimental
    Arm Title
    Azilsartan 10 mg QD
    Arm Type
    Experimental
    Arm Title
    Azilsartan 20 mg QD
    Arm Type
    Experimental
    Arm Title
    Azilsartan 40 mg QD
    Arm Type
    Experimental
    Arm Title
    Placebo QD
    Arm Type
    Placebo Comparator
    Arm Title
    Olmesartan 20 mg QD
    Arm Type
    Active Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    Azilsartan
    Other Intervention Name(s)
    TAK-536
    Intervention Description
    Azilsartan 2.5 mg, tablets, orally, once daily and olmesartan placebo-matching capsules and tablets, orally, once daily for up to 8 weeks.
    Intervention Type
    Drug
    Intervention Name(s)
    Azilsartan
    Other Intervention Name(s)
    TAK-536
    Intervention Description
    Azilsartan 5.0 mg, tablets, orally, once daily and olmesartan placebo-matching capsules and tablets, orally, once daily for up to 8 weeks.
    Intervention Type
    Drug
    Intervention Name(s)
    Azilsartan
    Other Intervention Name(s)
    TAK-536
    Intervention Description
    Azilsartan 10 mg, tablets, orally, once daily and olmesartan placebo-matching capsules and tablets, orally, once daily for up to 8 weeks.
    Intervention Type
    Drug
    Intervention Name(s)
    Azilsartan
    Other Intervention Name(s)
    TAK-536
    Intervention Description
    Azilsartan 20 mg, tablets, orally, once daily and olmesartan placebo-matching capsules and tablets, orally, once daily for up to 8 weeks.
    Intervention Type
    Drug
    Intervention Name(s)
    Azilsartan
    Other Intervention Name(s)
    TAK-536
    Intervention Description
    Azilsartan 40 mg, tablets, orally, once daily and olmesartan placebo-matching capsules and tablets, orally, once daily for up to 8 weeks.
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Azilsartan placebo-matching tablets, orally, once daily and olmesartan placebo-matching capsules, orally, once daily for up to 8 weeks.
    Intervention Type
    Drug
    Intervention Name(s)
    Olmesartan
    Other Intervention Name(s)
    Benicar®, Olmetec®
    Intervention Description
    Azilsartan placebo-matching tablets, orally, once daily and olmesartan 20 mg, capsules, orally, once daily for up to 8 weeks.
    Primary Outcome Measure Information:
    Title
    Change from Baseline in sitting clinic diastolic blood pressure.
    Time Frame
    Week 8 or Final Visit
    Secondary Outcome Measure Information:
    Title
    Change from Baseline in sitting clinic systolic blood pressure.
    Time Frame
    Weeks 2, 4, 6, and 8 or Final Visit
    Title
    The change from Baseline in standing clinic diastolic blood pressure and systolic blood pressure.
    Time Frame
    Weeks 2, 4, 6, and 8 or Final Visit
    Title
    Change from Baseline in diastolic blood pressure and systolic blood pressure as measured by ambulatory blood pressure monitoring.
    Time Frame
    Week 8 or Final Visit

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Has mild to moderate uncomplicated essential hypertension (diastolic blood pressure between 95 and 114 mm Hg at Screening Day -7 and randomization visit). Female patients of childbearing potential must be nonpregnant and nonlactating, and utilizing an acceptable method of contraception. Has clinical laboratory evaluations (including clinical chemistry, hematology, and complete urinalysis) within the reference range for the testing laboratory unless the results are deemed not clinically significant for inclusion into this study by the investigator or sponsor. Is willing to discontinue current antihypertensive medications. Exclusion Criteria: Has a decrease of more than or equal to 8 mm Hg in clinic diastolic blood pressure between Screening Day -7 and randomization visit. Is hypersensitive to angiotensin II receptor blockers. The patient has Grade 3 or 4 hypertensive retinopathy (Keith-Wagener scale). Has significant cardiac disease (eg, primary, hemodynamically significant cardiac valvular disease) other than mild to moderate uncomplicated hypertensive cardiovascular disease. Has taken, within 7 days prior to placebo run-in, or is expected to take, medications known to affect blood pressure, including the following: Diuretics Anti-hypertensives Vasodilators Tricyclic antidepressants Monoamine oxidase inhibitors Phenothiazines Diet medications Amphetamines or their derivatives Thiazolidinediones Lithium Chronic use of common cold medications or nonsteroidal anti-inflammatory drugs including aspirin >325 mg/day or cyclooxygenase-2 inhibitors). Has a history of myocardial infarction complicated by heart failure, post-myocardial infarction angina, hypertensive encephalopathy, or cerebrovascular accident. Has clinically significant cardiac conduction defects (eg, 2nd or 3rd degree atrioventricular block, left bundle branch block, sick sinus syndrome, atrial fibrillation or flutter). Has secondary hypertension of any etiology (eg, renal disease, pheochromocytoma, Cushing's syndrome). Has a history of collagen vascular disorder (eg systemic lupus erythematosus, scleroderma) within the last five years. Has an upper arm circumference less than 24 or greater than 42 cm. Works night (3rd) shift. Is non-compliant (less than 80%) with study medication during placebo run-in period. Has significant, moderate to severe renal dysfunction or disease (including renal artery stenosis). Has a history of drug abuse (defined as illicit drug use) or a history of alcohol abuse (defined as regular or daily consumption of more than 4 alcoholic drinks per day) within the past 2 years. Has a previous history of cancer, other than basal cell carcinoma, that has not been in remission for at least 5 years prior to the first dose of study drug. Has Type I or Type II diabetes mellitus. Has an alanine transaminase or aspartate transaminase level of greater than 3 times the upper limit of normal, active liver disease, or jaundice. Is participating in another investigational study or has participated in an investigational study within 30 days prior to randomization. Has -any other serious disease or condition at Screening (or randomization) that would compromise patient safety, might affect life expectancy, or make it difficult to successfully manage and follow the patient according to the protocol.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    VP Clinical Science Strategy
    Organizational Affiliation
    Takeda
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    Efficacy and Safety of Azilsartan in Subjects With Essential Hypertension

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