Phase IIa Study of the Product QGC001 Compared With Placebo in Patients With Essential Hypertension (2QG1)
Primary Purpose
Essential Hypertension
Status
Completed
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
QGC001
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Essential Hypertension
Eligibility Criteria
Inclusion Criteria:
- Male and female of non-childbearing potential patients (post-menopausal since at least 12 months or surgically sterilized) aged 18 to 75 years;
- Body weight ≥50 kg with a body mass index (BMI) calculated as weight in kg/(height in m2) from 18 to 40 kg/m2 at screening;
- A signed and dated informed consent form before any study-specific screening procedure is performed;
With a diagnosis of essential grade I or II hypertension defined as:
- a supine office systolic BP (SBP) of 140-159 mmHg or diastolic BP (DBP) of 90-99 mmHg who should have an additional clinical indication according to ESH guidelines for antihypertensive treatment after a 2-week placebo run-in period,
- or a supine office SBP of 160-179 mmHg or DBP of 100-109 mmHg after a 2-week placebo run-in period with a diagnosis of essential grade II hypertension;
- Diagnosis of permanent hypertension confirmed by a mean SBP or DBP higher than135 or 85 mmHg on daytime ambulatory blood pressure monitoring (ABPM) after a 2-week placebo run-in period;
- Estimated glomerular filtration rate (Modification of Diet in Renal Disease (MDRD) formula) ≥ 60 ml/min/1.73 m2.
Exclusion Criteria:
- Any significant hepatic, renal, respiratory (e.g., asthma), gastrointestinal, endocrine (e.g., diabetes, dyslipidemia necessitating drug therapy), immunologic, dermatological, hematological, neurologic, psychiatric disease or history of any clinically important drug allergy;
- Acute disease state (e.g., vomiting, fever, diarrhea) within 7 days before study day 1;
- Any history of transient ischemic accident (TIA) or cerebrovascular accident (CVA);
- Any history of acute heart failure or heart failure;
- Any history of myocardial infarction, unstable angina, coronary bypass or percutaneous coronary angioplasty;
- History of malignant tumor during the past 5 years;
- Any medical or surgical disorder considered by the investigator as increasing the risks of participation in the study, or liable to prevent the patient from complying with the requirements of the study or from continuing the study to completion;
- Any situation which, in the investigator's opinion, might compromise assessment of efficacy or of safety;
- History of non-adherence to treatment;
- History of drug abuse within 1 year before study day 1;
- History of alcoholism within 1 year before day 1;
- Positive serologic findings for human immunodeficiency virus (HIV) antibodies, hepatitis B surface antigen (HBsAg), and/or hepatitis C virus (HCV) antibodies;
- Use of any investigational drug within 30 days before IMP administration;
- Donation of blood (i.e., 500 ml) within 90 days before study day 1;
- Known secondary hypertension;
- Grade III hypertension;
- Estimated glomerular filtration rate (MDRD formula) below 60 ml/min/1.73 m2 ;
- Type I diabetes mellitus or uncontrolled type II diabetes mellitus (HbA1C ≥ 8%);
- Severe obesity (BMI ≥ 40 kg/m2);
- Arm circumference ≥ 42 cm;
- Atrial fibrillation;
- Known hypersensitivity to drugs;
- History of spontaneous or drug induced angioneurotic edema;
Use of any of the following medications within the four (4) weeks prior to dosing:
- Thyroid medication, statin therapy, oral antidiabetic drugs, estrogen replacement therapy and/or chronic low dose aspirin (75 mg/day) unless the patient has been on a stable maintenance dose for at least 3 months prior to screening.
- Anticoagulant treatments
- Cholestyramine resins.
- Treatment with oral, topical, inhaled, eye drop corticosteroids
- Treatment with class Ia, Ib and Ic or III anti-arrhythmics
- CNS drugs
- P-glycoprotein (P-gp) inhibitors (e.g., verapamil, quinidine, ritonavir),
- known cytochrome P450 inducers or inhibitors (eg, ketoconazole/CYP3A4, quinidine/CYP2D6, gemfibrozil/CYP2C8)
- Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDS) or cyclooxygenase (COX)-2 inhibitors.
- Vasodilators or vascular muscle relaxants prescribed for other conditions
- Unlikely to cooperate in the study and/or poor compliance anticipated by the investigator, e.g., uncooperative attitude, inability to return for follow-up visit, and unlikelihood of completing the study;
- Participation in another interventional study at the same time or within 3 months prior to the beginning of the present study;
- Participant not affiliated with the French social security;
- No written informed consent;
- A marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval >450 ms);
- A history of additional risk factors for Torsade de Pointes (TdP) (e.g., heart failure, hypokalemia, family history of Long QT Syndrome);
- The use of concomitant medications that prolong the QT/QTc interval.
Sites / Locations
- Hôpital Arthur Gardiner
- Hôpital Cardiologique, CHRU de Lille
- Hospices Civils de Lyon - Hôpital de la Croix Rousse
- Hôpital Européen Georges Pompidou
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
A: P1-QGC001 - Washout-placebo - P2-placebo
B: P1-placebo - Washout-placebo - P2-QGC001
Arm Description
The first period (P1) will correspond either to QGC001 or placebo, the second period (P2) will correspond either to QGC001 or placebo.
The first period (P1) will correspond either to QGC001 or placebo, the second period (P2) will correspond either to QGC001 or placebo.
Outcomes
Primary Outcome Measures
Efficacy - 24h ABPM
Measurements will include mean 24h systolic and diastolic pressures, and daytime values (measured every 15 min from 07:00 am to 10:00 pm) and night-time values (measured every 20 min from 10:00 pm to 07:00 am). Only ambulatory BP recordings with a minimum of 24 measurements will be considered as successful.
Secondary Outcome Measures
Efficacy - Self BP measurements at home
Additional information will be obtained from self-measurement of BP at home (HBP) with an automatic validated device. To be performed for 7 consecutive days just before the planned visit.
Efficacy - Office BP measurements
Office SBP, DBP and HR measured after resting in the semi-recumbent position for at least 5 min. Office SBP, DBP and HR measured after 1 min in a standing position will be recorded at each visit, immediately before the administration of the study drug.
Efficacy - Hormonal measurements
The pharmacodynamic neurohormonal effects of QGC001 will be assessed by measurements of plasma active renin, aldosterone, cortisol, adrenocorticotropic hormone (ACTH), apelin and copeptin as well as urine aldosterone, cortisol, creatinine, sodium and potassium using commercially available validated assays.
Pharmacokinetics - Plasma levels of QGC001
Four (4) PK blood samples will be taken. Plasma levels of QGC001 and its metabolite EC33 will be measured using validated LC/MS/MS methods.
Pharmacokinetics - Plasma levels of EC33
Four (4) PK blood samples will be taken. Plasma levels of QGC001 and its metabolite EC33 will be measured using validated LC/MS/MS methods.
Safety - Reported signs and symptoms
Patients will report to the center at approximately 08:00 am, without having taken their morning dose, to undergo safety assessments.
Safety - Physical examination
The physical examinations will be performed by the investigator or his/her representatives.
Safety - Vital sign measurements
For OBP measurements, three consecutive (2 min interval) SBP/DBP measurements will be done with an adapted cuff after resting in the semi-recumbent position for at least 5 min using a validated oscillometric semi-automatic device. In addition, SBP, DBP and HR will be measured after 1 min in a standing position.
Safety - Adverse events
Safety - Morisky Medication Adherence Questionnaire
Safety - Electrocardiogram
The measurements will consist of a 12-lead digital ECG.
Safety - Clinical laboratory tests
These include blood cells count, fasting glucose, sodium, potassium, chlorides, bicarbonates, creatinine, uric acid, total proteins, total cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), bilirubin, gamma glutamyl transferase (GammaGT), alkaline phosphatases.
Full Information
NCT ID
NCT02322450
First Posted
December 11, 2014
Last Updated
September 27, 2016
Sponsor
Quantum Genomics SA
1. Study Identification
Unique Protocol Identification Number
NCT02322450
Brief Title
Phase IIa Study of the Product QGC001 Compared With Placebo in Patients With Essential Hypertension
Acronym
2QG1
Official Title
Multicenter, Randomized, Double-blind, Two-period, Placebo Controlled, Forced-titration Proof of Concept Crossover Study to Compare QGC001 With Placebo in Patients With Grade I or II Essential Hypertension
Study Type
Interventional
2. Study Status
Record Verification Date
September 2016
Overall Recruitment Status
Completed
Study Start Date
January 2015 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
April 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Quantum Genomics SA
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
2QG1 is a Phase IIa study aiming to assess the blood pressure lowering effect of 4-week administration of QGC001 oral doses in patients with grade I or II essential hypertension compared to placebo, to assess the safety and tolerability, to obtain preliminary PK information for QGC001 given as multiple oral doses and to determine preliminary PD profile of QGC001 multiple oral doses on plasma and urine hormones, which will be compared to that of placebo.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Essential Hypertension
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
34 (Actual)
8. Arms, Groups, and Interventions
Arm Title
A: P1-QGC001 - Washout-placebo - P2-placebo
Arm Type
Experimental
Arm Description
The first period (P1) will correspond either to QGC001 or placebo, the second period (P2) will correspond either to QGC001 or placebo.
Arm Title
B: P1-placebo - Washout-placebo - P2-QGC001
Arm Type
Experimental
Arm Description
The first period (P1) will correspond either to QGC001 or placebo, the second period (P2) will correspond either to QGC001 or placebo.
Intervention Type
Drug
Intervention Name(s)
QGC001
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Efficacy - 24h ABPM
Description
Measurements will include mean 24h systolic and diastolic pressures, and daytime values (measured every 15 min from 07:00 am to 10:00 pm) and night-time values (measured every 20 min from 10:00 pm to 07:00 am). Only ambulatory BP recordings with a minimum of 24 measurements will be considered as successful.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks (end-of-study visit).
Secondary Outcome Measure Information:
Title
Efficacy - Self BP measurements at home
Description
Additional information will be obtained from self-measurement of BP at home (HBP) with an automatic validated device. To be performed for 7 consecutive days just before the planned visit.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Efficacy - Office BP measurements
Description
Office SBP, DBP and HR measured after resting in the semi-recumbent position for at least 5 min. Office SBP, DBP and HR measured after 1 min in a standing position will be recorded at each visit, immediately before the administration of the study drug.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Efficacy - Hormonal measurements
Description
The pharmacodynamic neurohormonal effects of QGC001 will be assessed by measurements of plasma active renin, aldosterone, cortisol, adrenocorticotropic hormone (ACTH), apelin and copeptin as well as urine aldosterone, cortisol, creatinine, sodium and potassium using commercially available validated assays.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Pharmacokinetics - Plasma levels of QGC001
Description
Four (4) PK blood samples will be taken. Plasma levels of QGC001 and its metabolite EC33 will be measured using validated LC/MS/MS methods.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Pharmacokinetics - Plasma levels of EC33
Description
Four (4) PK blood samples will be taken. Plasma levels of QGC001 and its metabolite EC33 will be measured using validated LC/MS/MS methods.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Safety - Reported signs and symptoms
Description
Patients will report to the center at approximately 08:00 am, without having taken their morning dose, to undergo safety assessments.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Safety - Physical examination
Description
The physical examinations will be performed by the investigator or his/her representatives.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Safety - Vital sign measurements
Description
For OBP measurements, three consecutive (2 min interval) SBP/DBP measurements will be done with an adapted cuff after resting in the semi-recumbent position for at least 5 min using a validated oscillometric semi-automatic device. In addition, SBP, DBP and HR will be measured after 1 min in a standing position.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Safety - Adverse events
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Safety - Morisky Medication Adherence Questionnaire
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Safety - Electrocardiogram
Description
The measurements will consist of a 12-lead digital ECG.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
Title
Safety - Clinical laboratory tests
Description
These include blood cells count, fasting glucose, sodium, potassium, chlorides, bicarbonates, creatinine, uric acid, total proteins, total cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), bilirubin, gamma glutamyl transferase (GammaGT), alkaline phosphatases.
Time Frame
Change from Period 1 to Period 2 up to 16 weeks.
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:
Male and female of non-childbearing potential patients (post-menopausal since at least 12 months or surgically sterilized) aged 18 to 75 years;
Body weight ≥50 kg with a body mass index (BMI) calculated as weight in kg/(height in m2) from 18 to 40 kg/m2 at screening;
A signed and dated informed consent form before any study-specific screening procedure is performed;
With a diagnosis of essential grade I or II hypertension defined as:
a supine office systolic BP (SBP) of 140-159 mmHg or diastolic BP (DBP) of 90-99 mmHg who should have an additional clinical indication according to ESH guidelines for antihypertensive treatment after a 2-week placebo run-in period,
or a supine office SBP of 160-179 mmHg or DBP of 100-109 mmHg after a 2-week placebo run-in period with a diagnosis of essential grade II hypertension;
Diagnosis of permanent hypertension confirmed by a mean SBP or DBP higher than135 or 85 mmHg on daytime ambulatory blood pressure monitoring (ABPM) after a 2-week placebo run-in period;
Estimated glomerular filtration rate (Modification of Diet in Renal Disease (MDRD) formula) ≥ 60 ml/min/1.73 m2.
Exclusion Criteria:
Any significant hepatic, renal, respiratory (e.g., asthma), gastrointestinal, endocrine (e.g., diabetes, dyslipidemia necessitating drug therapy), immunologic, dermatological, hematological, neurologic, psychiatric disease or history of any clinically important drug allergy;
Acute disease state (e.g., vomiting, fever, diarrhea) within 7 days before study day 1;
Any history of transient ischemic accident (TIA) or cerebrovascular accident (CVA);
Any history of acute heart failure or heart failure;
Any history of myocardial infarction, unstable angina, coronary bypass or percutaneous coronary angioplasty;
History of malignant tumor during the past 5 years;
Any medical or surgical disorder considered by the investigator as increasing the risks of participation in the study, or liable to prevent the patient from complying with the requirements of the study or from continuing the study to completion;
Any situation which, in the investigator's opinion, might compromise assessment of efficacy or of safety;
History of non-adherence to treatment;
History of drug abuse within 1 year before study day 1;
History of alcoholism within 1 year before day 1;
Positive serologic findings for human immunodeficiency virus (HIV) antibodies, hepatitis B surface antigen (HBsAg), and/or hepatitis C virus (HCV) antibodies;
Use of any investigational drug within 30 days before IMP administration;
Donation of blood (i.e., 500 ml) within 90 days before study day 1;
Known secondary hypertension;
Grade III hypertension;
Estimated glomerular filtration rate (MDRD formula) below 60 ml/min/1.73 m2 ;
Type I diabetes mellitus or uncontrolled type II diabetes mellitus (HbA1C ≥ 8%);
Severe obesity (BMI ≥ 40 kg/m2);
Arm circumference ≥ 42 cm;
Atrial fibrillation;
Known hypersensitivity to drugs;
History of spontaneous or drug induced angioneurotic edema;
Use of any of the following medications within the four (4) weeks prior to dosing:
Thyroid medication, statin therapy, oral antidiabetic drugs, estrogen replacement therapy and/or chronic low dose aspirin (75 mg/day) unless the patient has been on a stable maintenance dose for at least 3 months prior to screening.
Anticoagulant treatments
Cholestyramine resins.
Treatment with oral, topical, inhaled, eye drop corticosteroids
Treatment with class Ia, Ib and Ic or III anti-arrhythmics
CNS drugs
P-glycoprotein (P-gp) inhibitors (e.g., verapamil, quinidine, ritonavir),
known cytochrome P450 inducers or inhibitors (eg, ketoconazole/CYP3A4, quinidine/CYP2D6, gemfibrozil/CYP2C8)
Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDS) or cyclooxygenase (COX)-2 inhibitors.
Vasodilators or vascular muscle relaxants prescribed for other conditions
Unlikely to cooperate in the study and/or poor compliance anticipated by the investigator, e.g., uncooperative attitude, inability to return for follow-up visit, and unlikelihood of completing the study;
Participation in another interventional study at the same time or within 3 months prior to the beginning of the present study;
Participant not affiliated with the French social security;
No written informed consent;
A marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval >450 ms);
A history of additional risk factors for Torsade de Pointes (TdP) (e.g., heart failure, hypokalemia, family history of Long QT Syndrome);
The use of concomitant medications that prolong the QT/QTc interval.
Facility Information:
Facility Name
Hôpital Arthur Gardiner
City
Dinard
ZIP/Postal Code
35800
Country
France
Facility Name
Hôpital Cardiologique, CHRU de Lille
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
Hospices Civils de Lyon - Hôpital de la Croix Rousse
City
Lyon
ZIP/Postal Code
69317
Country
France
Facility Name
Hôpital Européen Georges Pompidou
City
Paris
ZIP/Postal Code
75015
Country
France
12. IPD Sharing Statement
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
30882604
Citation
Azizi M, Courand PY, Denolle T, Delsart P, Zhygalina V, Amar L, Lantelme P, Mounier-Vehier C, De Mota N, Balavoine F, Llorens-Cortes C. A pilot double-blind randomized placebo-controlled crossover pharmacodynamic study of the centrally active aminopeptidase A inhibitor, firibastat, in hypertension. J Hypertens. 2019 Aug;37(8):1722-1728. doi: 10.1097/HJH.0000000000002092.
Results Reference
derived
Learn more about this trial
Phase IIa Study of the Product QGC001 Compared With Placebo in Patients With Essential Hypertension
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