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Sham Controlled Study of Renal Denervation for Untreated Stage I and II Hypertension

Primary Purpose

Hypertension

Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Ultrasound
Sham Ultrasound
Sponsored by
Kona Medical Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypertension focused on measuring Hypertension, Renal Denervation

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject is at least 18 years of age and no more than 80 years of age and can be safely removed from present antihypertensive therapy.
  2. Subject has not been taking any anti-hypertensive medications for at least 6 months prior to study enrollment.
  3. Subjects must have an average office seated systolic BP (SBP) between 150 mmHg and 180 mmHg inclusive in the untreated state for a minimum of 2 weeks.
  4. Mean daytime ambulatory SBP > 135 mmHg and no more than 170 mmHg in addition to mean daytime ambulatory DBP > 85 mmHg.
  5. Subject has two functioning kidneys.
  6. Subject has an eGFR value of ≥ 30 ml/min/1.73 m² (MDRD formula).

Exclusion Criteria:

a.Any known secondary causes of hypertension.

b.Evidence of current or past history of any clinically significant renal artery stenosis on duplex ultrasound as defined by a finding of at least one of the following:

  1. Peak systolic velocity (PSV) in the main renal artery of 150 cm/s or greater;
  2. Renal/aortic ratio (RAR) of greater than 3.5; or
  3. Complete lack of Doppler signal in any portion of the main renal artery (signifying complete occlusion).

c.Previously documented finding of a 30% or greater renal artery stenosis in any renal arterial vessels as determined by angiographic examination, MRA or CTA.

d.Kidney stones that are 1 cm or greater in size, or that are symptomatic. e.History of intra-abdominal surgery within the past six months or surgery through retroperitoneal path at any time .

f.Previous renal denervation g.Previous renal transplant. h.Heterogeneities in kidney morphology, such as large cysts or tumors (> 2 cm), which are determined at discretion of the investigator to potentially interfere with treatment.

i.Hemodynamically unstable valvular heart disease for which BP reduction would be hazardous in the judgment of the site investigator-physician.

j.Documented history of severe orthostatic hypotension that requires treatment or has necessitated hospitalization.

k.Primary pulmonary hypertension l.History of myocardial infarction, unstable angina pectoris, or cerebrovascular accident within the last six months.

m.BMI over 35 kg/m² and/or mid-arm circumference > 45 cm (creates difficulty with ABPM measurements) n.Anatomy that precludes treatment as determined by the Surround Sound System. This may include any of the following:

  1. Target treatment depth as measured by the Surround Sound System of greater than 13 cm (Skin to target);
  2. Lack of visualization of the renal artery and or renal artery Doppler signal with the Surround Sound System;
  3. Lack of visualization of the renal parenchyma due to obscuration by bowel or other abdominal or retroperitoneal structures; or
  4. Narrow window between the superior margin of the iliac crest and the inferior margin of the lowest rib that prevents adequate positioning of both the Surround Sound imaging probe and the treatment unit.

o.Subject is pregnant , nursing, or intends to become pregnant during the study period.

p.Enrollment in another interventional research protocol. q.Any condition that, at the discretion of the investigator, would preclude participation in the study.

r.Subject is unable, or unwilling, to comply with the protocol-required follow-up schedule.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Sham Comparator

    Arm Label

    Investigational Therapy (Surround Sound)

    Sham Control

    Arm Description

    Investigational Therapy using external focused ultrasound

    Blinded Sham Control Arm

    Outcomes

    Primary Outcome Measures

    Safety will be assessed by incidence of Major Adverse Events (MAE), defined as a composite of the following events:
    All cause mortality; End-stage Renal Disease defined as eGFR < 15 ml/min or need for renal replacement therapy Hospitalization for hypertensive crisis not related to confirmed non-adherence with medications as assessed by toxicological and other medical analyses and testing. OR - New renal artery stenosis > 70% confirmed by angiography within 3 months of randomization
    Change in Office Systolic Blood Pressure (OBP) as measured from screening visit one to the 3 months post randomization follow-up visit.

    Secondary Outcome Measures

    Full Information

    First Posted
    June 21, 2015
    Last Updated
    January 6, 2016
    Sponsor
    Kona Medical Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02480517
    Brief Title
    Sham Controlled Study of Renal Denervation for Untreated Stage I and II Hypertension
    Official Title
    Wave VI Feasibility Study: Phase II Randomized Sham Controlled Study of Renal Denervation for Untreated Stage I and II Hypertension
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2016
    Overall Recruitment Status
    Unknown status
    Study Start Date
    September 2016 (undefined)
    Primary Completion Date
    March 2017 (Anticipated)
    Study Completion Date
    December 2017 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Kona Medical Inc.

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The Wave VI study is a, multicenter, prospective, double-blind, randomized, sham controlled feasibility study of the safety of renal denervation in patients with stage I and II hypertension who have an average office systolic blood pressure between 150 and 180 mmHg and have not been on any antihypertensive medications for at least six months.
    Detailed Description
    The primary objective of this feasibility study is to assess the safety of renal denervation using externally focused therapeutic ultrasound with non-invasive targeting for patients with stage I and II hypertension who are not on any antihypertensive medications. The key secondary objective is to assess the effect of the therapy on changes from baseline in ambulatory systolic BP.

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    60 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Investigational Therapy (Surround Sound)
    Arm Type
    Experimental
    Arm Description
    Investigational Therapy using external focused ultrasound
    Arm Title
    Sham Control
    Arm Type
    Sham Comparator
    Arm Description
    Blinded Sham Control Arm
    Intervention Type
    Device
    Intervention Name(s)
    Ultrasound
    Other Intervention Name(s)
    Surround Sound
    Intervention Type
    Device
    Intervention Name(s)
    Sham Ultrasound
    Primary Outcome Measure Information:
    Title
    Safety will be assessed by incidence of Major Adverse Events (MAE), defined as a composite of the following events:
    Description
    All cause mortality; End-stage Renal Disease defined as eGFR < 15 ml/min or need for renal replacement therapy Hospitalization for hypertensive crisis not related to confirmed non-adherence with medications as assessed by toxicological and other medical analyses and testing. OR - New renal artery stenosis > 70% confirmed by angiography within 3 months of randomization
    Time Frame
    3 months follow-up
    Title
    Change in Office Systolic Blood Pressure (OBP) as measured from screening visit one to the 3 months post randomization follow-up visit.
    Time Frame
    Baseline and 3 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    80 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Subject is at least 18 years of age and no more than 80 years of age and can be safely removed from present antihypertensive therapy. Subject has not been taking any anti-hypertensive medications for at least 6 months prior to study enrollment. Subjects must have an average office seated systolic BP (SBP) between 150 mmHg and 180 mmHg inclusive in the untreated state for a minimum of 2 weeks. Mean daytime ambulatory SBP > 135 mmHg and no more than 170 mmHg in addition to mean daytime ambulatory DBP > 85 mmHg. Subject has two functioning kidneys. Subject has an eGFR value of ≥ 30 ml/min/1.73 m² (MDRD formula). Exclusion Criteria: a.Any known secondary causes of hypertension. b.Evidence of current or past history of any clinically significant renal artery stenosis on duplex ultrasound as defined by a finding of at least one of the following: Peak systolic velocity (PSV) in the main renal artery of 150 cm/s or greater; Renal/aortic ratio (RAR) of greater than 3.5; or Complete lack of Doppler signal in any portion of the main renal artery (signifying complete occlusion). c.Previously documented finding of a 30% or greater renal artery stenosis in any renal arterial vessels as determined by angiographic examination, MRA or CTA. d.Kidney stones that are 1 cm or greater in size, or that are symptomatic. e.History of intra-abdominal surgery within the past six months or surgery through retroperitoneal path at any time . f.Previous renal denervation g.Previous renal transplant. h.Heterogeneities in kidney morphology, such as large cysts or tumors (> 2 cm), which are determined at discretion of the investigator to potentially interfere with treatment. i.Hemodynamically unstable valvular heart disease for which BP reduction would be hazardous in the judgment of the site investigator-physician. j.Documented history of severe orthostatic hypotension that requires treatment or has necessitated hospitalization. k.Primary pulmonary hypertension l.History of myocardial infarction, unstable angina pectoris, or cerebrovascular accident within the last six months. m.BMI over 35 kg/m² and/or mid-arm circumference > 45 cm (creates difficulty with ABPM measurements) n.Anatomy that precludes treatment as determined by the Surround Sound System. This may include any of the following: Target treatment depth as measured by the Surround Sound System of greater than 13 cm (Skin to target); Lack of visualization of the renal artery and or renal artery Doppler signal with the Surround Sound System; Lack of visualization of the renal parenchyma due to obscuration by bowel or other abdominal or retroperitoneal structures; or Narrow window between the superior margin of the iliac crest and the inferior margin of the lowest rib that prevents adequate positioning of both the Surround Sound imaging probe and the treatment unit. o.Subject is pregnant , nursing, or intends to become pregnant during the study period. p.Enrollment in another interventional research protocol. q.Any condition that, at the discretion of the investigator, would preclude participation in the study. r.Subject is unable, or unwilling, to comply with the protocol-required follow-up schedule.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Omar Dawood
    Email
    odawood@konamedical.com

    12. IPD Sharing Statement

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    Sham Controlled Study of Renal Denervation for Untreated Stage I and II Hypertension

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