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Atacand Dose Ranging in Hypertensive Pediatric Subjects 1 Year to Less Than 6 Years of Age
This study is ongoing, but not recruiting participants.
Sponsored by: AstraZeneca
Information provided by: AstraZeneca
ClinicalTrials.gov Identifier: NCT00244621
  Purpose

This is a dose ranging study of candesartan cilexetil in hypertensive pediatric subjects ages 1 to less than 6 years of age. It employs a double blind, randomized, dose ranging design intended for conduct as a multicenter trial. There are 3 study 'periods': a 1-week placebo run-in, a 4-week double blind treatment, and a 52-week open-label, long-term treatment period. Subjects undergo a screening evaluation, then a 1-week single-blind, placebo run-in, after which eligible subjects are allocated to receive 1 of 3 dose levels of candesartan cilexetil (0.05 mg/kg, or 0.20 mg /kg or 0.40 mg /kg), liquid formulation, in a 1:1:1 ratio for 4-weeks. At the end of randomized dose allocation (Day 28), blood pressure assessment will be performed and subjects may begin the 52-week, open-label treatment period of the study.


Condition Intervention Phase
Hypertension
Drug: candesartan cilexetil (Atacand)
Phase III

MedlinePlus related topics: High Blood Pressure
Drug Information available for: Candesartan cilexetil CV 11974
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator), Dose Comparison, Parallel Assignment, Safety/Efficacy Study
Official Title: A Dose-Ranging Safety and Pharmacokinetics Study of Candesartan Cilexetil in Hypertensive Pediatric Subjects 1 to Less That 6 Years of Age: A 4-Week, Multicenter, Randomized, Double-Blind Study With a 1-Year, Open-Label, Follow-up Period.

Further study details as provided by AstraZeneca:

Primary Outcome Measures:
  • Characterize the dose response relationship of candesartan cilexetil in hypertensive pediatric subjects (1 to <6 years of age) by evaluation of the slope of the linear regression for the change in trough sitting systolic blood pressure (SiSBP) [ Time Frame: from baseline to the end of the double-blind phase (4 weeks) ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Evaluate the antihypertensive effects and the safety of candesartan cilexetil in hypertensive pediatric subjects by determining the dose response relationship of candesartan cilexetil for the change in sitting and supine diastolic and systolic BP [ Time Frame: from baseline to the end of the double-blind phase (4 weeks) ] [ Designated as safety issue: No ]
  • The mean change in urinary protein/creatinine and albumin/creatinine ratio [ Time Frame: from baseline to the end of the double-blind phase (4 weeks) ] [ Designated as safety issue: No ]
  • Safety as assessed by adverse events, adverse events that necessitate study drug discontinuation, serious adverse events, physical exam findings, growth, and laboratory tests [ Time Frame: from baseline to the end of the double-blind phase (4 weeks) + 52 weeks ] [ Designated as safety issue: No ]

Enrollment: 95
Study Start Date: November 2004
Estimated Study Completion Date: November 2008
Estimated Primary Completion Date: August 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
0.05 mg/kg Atacand oral liquid dose
Drug: candesartan cilexetil (Atacand)
0.05 mg/kg once daily oral liquid dose
2: Experimental
0.20 mg /kg Atacand oral liquid dose
Drug: candesartan cilexetil (Atacand)
0.20 mg/kg once daily oral liquid dose
3: Experimental
0.40 mg /kg Atacand oral liquid dose
Drug: candesartan cilexetil (Atacand)
0.40 mg/kg once daily oral liquid dose

  Eligibility

Ages Eligible for Study:   1 Year to 6 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Signed informed consent by a parent or a legal guardian.
  • Weight > 10 kg and < 40 kg.
  • SiSBP and/or SiDBP > 95th percentile and < 20 mm Hg (systolic) and/or 10 mm Hg (diastolic) above the 95th percentile at screening and at randomization based on height-adjusted charts for age and gender.

Exclusion Criteria:

  • Any situation, clinical condition or laboratory abnormality that, in the opinion of the investigator or sponsor, may interfere with the subject's participation in the study or would pose a significant risk to the subject or interfere with the assessment of safety and efficacy endpoints.
  • Weight < 10 kg and > 40 kg.
  • Less than 80% compliance with study medication during single-blind placebo screening as assessed by residual medication volume.
  • Hypertension secondary to pheochromocytoma, hyperthyroidism, or Cushing's Syndrome.
  • Uncorrected coarctation of the aorta, bilateral renal artery renal artery stenosis in a single kidney.
  • Estimated glomerular filtration rate (GFR) < 50 mL/min/1.73m 2 based on the Schwartz Formula (Schwartz et al, 1987).
  • Renal transplant < 6 months prior to study entry. Subjects who have received a renal transplant > 6 months prior to study entry may participate in the study if: 1) renal function is stable, 2) estimated GFR >50 mL/min/1.73m 2, 3) stable doses of immunosuppressive medications are anticipated throughout the 4-week, double-blind period of the study, 4) no episodes of acute allograft rejection have occurred within 30 days of study entry, and 5) the renal allograft has no documented renal artery stenosis.

Nephrotic syndrome not in remission.

  • Unstable insulin dependent diabetes mellitus.
  • Known bleeding, coagulation, or platelet disorder that could interfere with blood sampling.
  • Clinically significant valvular heart disease.
  • Clinical diagnosis of heart failure.
  • Clinically significant arrhythmia (eg, any arrhythmia requiring medical therapy or that causes symptoms).
  • Second or third degree AV block.
  • Impaired liver function defined as either acute liver disease or chronic liver disease with persistent liver enzyme values greater than 1½ times the upper limit of the reference range for aspartate aminotransferase (AST) or alanine aminotransferase (ALT).
  • Known hypersensitivity to ARBs.
  • Currently receiving an angiotensin receptor blocker or an angiotensin converting enzyme inhibitor that in the investigator's judgment cannot safely be withdrawn during the study.
  • Subjects receiving an angiotensin receptor blocker or an angiotensin converting enzyme inhibitor may be eligible if they undergo withdrawal of the antihypertensive medication over a 2-week washout period and subsequently meet BP inclusion/exclusion criteria.
  • Subjects currently receiving other classes of antihypertensive medications (eg, diuretics, calcium channel blockers or beta-blockers) and whose BP values meet inclusion/exclusion criteria may participate in the study while continuing their current antihypertensive medication regimen. Up to 2 concomitant antihypertensive medications are permitted. Doses and dose regimens of concomitant antihypertensive medications must remain unchanged during the 4-week double-blind period of the study.
  • Currently using, or used within 14 days prior to receiving double-blind medication, any concomitant medications which in the opinion of the investigator could negatively affect the subject.
  • Unable or unwilling to comply with the study requirements including blood sampling and swallowing study drug suspension.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00244621

  Show 38 Study Locations
Sponsors and Collaborators
AstraZeneca
Investigators
Study Director: AstraZeneca Atacand Medical Science Director, MD AstraZeneca
  More Information

Study ID Numbers: D2451C00002, 328
Study First Received: October 25, 2005
Last Updated: September 16, 2008
ClinicalTrials.gov Identifier: NCT00244621  
Health Authority: United States: Food and Drug Administration

Keywords provided by AstraZeneca:
Pediatric hypertension

Study placed in the following topic categories:
Candesartan cilexetil
Candesartan
Vascular Diseases
Angiotensin II
Hypertension

Additional relevant MeSH terms:
Angiotensin II Type 1 Receptor Blockers
Molecular Mechanisms of Pharmacological Action
Therapeutic Uses
Cardiovascular Diseases
Cardiovascular Agents
Antihypertensive Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009