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Study to Assess the Optimal Renoprotective Dose of Aliskiren in Hypertensive Patients With Type 2 Diabetes and Incipient or Overt Nephropathy
This study is ongoing, but not recruiting participants.
Sponsored by: Novartis
Information provided by: Novartis
ClinicalTrials.gov Identifier: NCT00464776
  Purpose

This study will assess the optimal renoprotective dose of Aliskiren in hypertensive type 2 diabetes patients with incipient or overt nephropathy


Condition Intervention Phase
Diabetes Type 2
Drug: Aliskiren
Phase I
Phase II

MedlinePlus related topics: Diabetes
Drug Information available for: Aliskiren
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Crossover Assignment, Safety/Efficacy Study
Official Title: A Randomized, Double-Blind, Cross-Over, 4-Period, 4 Treatment, Within-Subject Placebo-Controlled Study to Assess the Optimal Renoprotective Dose of Aliskiren in Hypertensive Type 2 Diabetic Patients With Incipient or Overt Nephropathy

Further study details as provided by Novartis:

Primary Outcome Measures:
  • Investigate the antiproteinuric effect of increasing doses of Aliskiren compared to matching placebo. [ Time Frame: End of study ]

Secondary Outcome Measures:
  • Assess the effect on Glomerular Filtration Rate (GFR) of multiple dose administration of Aliskiren. [ Time Frame: End of study ]
  • Assess the effect on blood pressure of multiple dose administration of Aliskiren. [ Time Frame: End of study ]
  • To investigate whether there is a change in biomarkers of inflammation and cardiovascular risk. [ Time Frame: End of study ]

Estimated Enrollment: 24
Study Start Date: October 2005
Estimated Study Completion Date: July 2008
Arms Assigned Interventions
1: Experimental
Various sequences of 3 doses of Aliskiren plus placebo
Drug: Aliskiren
2: Experimental
Various sequences of 3 doses of Aliskiren plus placebo
Drug: Aliskiren
3: Experimental
Various sequences of 3 doses of Aliskiren plus placebo
Drug: Aliskiren
4: Experimental
Various sequences of 3 doses of Aliskiren plus placebo
Drug: Aliskiren

  Eligibility

Ages Eligible for Study:   30 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male and/or female patients from 30-80 years of age.
  • Type 2 diabetes (defined using World Health Organization criteria)
  • Incipient or overt nephropathy (urinary albumin excretion 100 but ≤ 2000 mg/day).
  • Glomerular filtration rate (GFR) 40ml per minute
  • To be eligible for randomization, patients must fulfill the following criteria:

    1. Patients on ongoing hypertensive therapy must have a blood pressure ≥ 135/85 mm Hg but lower than 170/105 mm Hg at Visit 3 (Day -1, Period 1) AND patients must be on stable antihypertensive medications for at least 8 weeks prior to Visit 2 (Run-in period)
    2. Newly diagnosed hypertensive patients must have a blood pressure ≥ 135/85 mm Hg but lower than 170/105 mm Hg at Visit 3 (Day -1, Period 1)
  • Female patients must be postmenopausal or must have had a bilateral oophorectomy or must have been surgically sterilized or hysterectomized at least 6 months prior to screening
  • Oral body temperature within the range 35.0-37.5 °C
  • Able to provide written informed consent prior to study participation.
  • Able to communicate well with the investigator and comply with the requirements of the study.
  • Patients must be willing and medically able to discontinue anti-hypertensive treatment or any other medication which is prohibited in the study protocol.
  • Patients must be on stable hypoglycemic medications for at least 8 weeks prior to visit 1 (Screening visit).

Exclusion Criteria:

  • Use of any prescription drug or over-the-counter (OTC) medication which is prohibited by the protocol.
  • Severe Hypertension Grade 3 WHO classification Mean Sitting Diastolic Blood Pressure (MSDBP) 110 mmHg and/or Mean Sitting Systolic Blood Pressure MSSBP 180 mmHg)
  • Acetylsalicyclic acid (ASA) treatment >1g/day or regular use of Non steroidal anti-inflammatory drugs (NSAIDs)
  • Kidney disease not caused by diabetes or hypertension
  • Serum potassium < 3.5 or > 5.1 mEq/L
  • GFR < 40 ml/min/1.73m2 as measured by the Modification of Diet in Renal Disease (MDRD) formula
  • Serum albumin < 2.0mg/dL
  • History of hypertensive encephalopathy or cerebrovascular accident at any time prior to Visit 1
  • Transient ischemic cerebral attack during the 6 months prior to Visit 1
  • Current diagnosis of heart failure New York Heart Association (NYHA) Class II-IV
  • History of myocardial infarction, unstable angina pectoris, coronary bypass surgery, or any percutaneous coronary intervention (PCI) during the 6 months prior to Visit 1
  • Second or third degree heart block without a pacemaker
  • Concurrent potentially life threatening arrhythmia or symptomatic arrhythmia
  • Clinically significant valvular heart disease
  • Type 1 diabetes mellitus
  • Uncontrolled Type II diabetes mellitus Hemoglobin subtype A1C (HbA1C) >11 %
  • History of malignancy including leukemia and lymphoma (but not basal cell skin carcinoma) within the past five years
  • Pregnant or nursing women
  • Participation in any clinical investigation within 4 weeks prior to dosing or longer if required by local regulation.
  • Donation or loss of 400 mL or more of blood within 8 weeks prior to dosing.
  • Significant illness within the two weeks prior to dosing.
  • Any surgical or medical condition which might significantly alter the absorption, distribution, metabolism, or excretion of study drugs including, but not limited to, any of the following:

    • History of major gastrointestinal tract surgery such as gastrectomy, gastroenterostomy, or bowel resection
    • Currently active or previously active inflammatory bowel disease during the 12 months prior to Visit 1
    • Currently active gastritis, duodenal or gastric ulcers, or gastrointestinal/rectal bleeding during the 3 months prior to Visit 1.
    • Any history of pancreatic injury, pancreatitis or evidence of impaired pancreatic function/injury as indicated by abnormal lipase or amylase
    • Evidence of hepatic disease, a history of hepatic encephalopathy, a history of esophageal varices, or a history of portocaval shunt
    • Current treatment with cholestyramine or cholestipol resins
  • History of immunocompromise, including a positive HIV test result.
  • History of a positive Hepatitis B surface antigen (HBsAg) or Hepatitis C test result.
  • History of drug or alcohol abuse within the 12 months prior to dosing.
  • Persons directly involved in the execution of this protocol.
  • Any condition that in the opinion of the investigator or the Novartis medical monitor would jeopardize the evaluation of efficacy or safety
  • History of noncompliance to medical regimens or unwillingness to comply with the study protocol
  • Known or suspected contraindications to the study medications, including history of allergy to ACE inhibitors and/or to thiazide diuretics or other sulfonamide derived drug
  • Any surgical or medical condition, which in the opinion of the investigator, may place the patient at higher risk from his/her participation in the study, or is likely to prevent the patient from complying with the requirements of the study or completing the study
  • Patients who previously participated in any Aliskiren study.

Other protocol-defined inclusion/exclusion criteria may apply

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00464776

Locations
Denmark
Novartis
Gentofte, Denmark, 2820
Sponsors and Collaborators
Novartis
Investigators
Principal Investigator: Novartis Investigative site
  More Information

Responsible Party: Novartis ( External Affairs )
Study ID Numbers: CSPP100A2240
Study First Received: April 21, 2007
Last Updated: June 20, 2008
ClinicalTrials.gov Identifier: NCT00464776  
Health Authority: Denmark: Danish Medicines Agency

Keywords provided by Novartis:
Randomized
double-blind
cross-over
4-period
4 treatment
within-subject placebo-controlled study
assess optimal renoprotective dose of Aliskiren
hypertensive type 2 diabetes patients
incipient or overt nephropathy

Study placed in the following topic categories:
Metabolic Diseases
Urologic Diseases
Diabetes Mellitus, Type 2
Diabetes Mellitus
Endocrine System Diseases
Endocrinopathy
Kidney Diseases
Metabolic disorder
Glucose Metabolism Disorders

ClinicalTrials.gov processed this record on January 16, 2009