Evaluation of Aliskiren Efficacy by Different Methods of Blood Pressure Measurements (REALITY)

January 10, 2017 updated by: Meir Medical Center

Treatment of Essential Hypertension With Rasilez. Evaluation of Different Methods of Blood Pressure Measurements - Efficacy and Safety Evaluation

Almost 50% of hypertensive patients remain uncontrolled. Clinical decisions are mostly based on office blood pressure,despite the fallacies of this method of measurement. Other reasons for not achieving blood pressure targets are lack of 24-hr efficacy and tolerability of existing anti-hypertensive drug classes. Aliskiren (Rasilez®) is a new antihypertensive drug, given once a day.

The purpose of the REALITY study-[tREAtment of essentiaL hypertension with rasIlez. evaluation of different methods of blood pressure measurements - efficacy and safeTY evaluation -] is to evaluate the efficacy, and tolerability of aliskiren in a "real life" setting. The efficacy of the drug will be evaluated using 24 hour ambulatory blood pressure monitoring (ABPM). Results will be compared with office, nurse or self blood pressure monitoring. This comparison will allow to decide which follow-up technique is better for those hypertensive patients.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

This is a single centre observational uncontrolled prospective study, Hypertensive patients that are either treatment naïve or uncontrolled on current monotherapy and meet all inclusion and exclusion criteria, will be assigned to Rasilez treatment (start for 2 weeks on 150 mg and if well tolerated the dosage will be increased to 300 mg). The treatment will then be continued for additional 10 weeks. Rasilez can be administrated as monotherapy or as add on to other antihypertensive (patients currently on single medication).

The patient will have additional visits at week 6, and at week 12 For all eligible patients a 24 h ABPM test will be performed at the week prior to visit 2 (treatment initiation) and at the week prior to the final visit.

Each patient will receive an automatic blood pressure monitor [OMRON MX3 plus] for SBPM measurements, The monitor will be provided by the sponsor for the whole study period. The patient will be trained for blood pressure measurements. SBPM will be performed twice a week [morning and evening] Nurse blood pressure measurements will be performed at each visit, after 10 minutes of rest, prior to the medical visit.

Office blood pressure will be performed by the physician at each visit Blood samples for electrolytes, renal function, liver function and hematology, will be taken at base line visit, at week 2 and at week 12 Other antihypertensive can be added at any time during the study, according to the decision of the investigator, except ACE inhibitors and ARBs.

AEs have to be reported at the appropriate site on the CRF page. In case of discontinuation of aliskiren or interruption of aliskiren treatment the reason has to be given. Serious adverse events (SAEs) have to be documented additionally on the separate SAE form and have to be reported within 24h to the NOVARTIS Pharma, Drug safety department Adherence to treatment will be evaluated using standard formulas. Estimated time for recruitment of 50 patients: One year. Study design scheme Visit 1 -[week -2] physician and nurse BP. Sign inform consent- command ABPM a week prior to visit 2 - SBPM training Visit 2 [week 0] physician and nurse BP. Start Rasilez 150 mg and command laboratory exams prior to next visit.

Visit 3 [week 2] physician and nurse BP. Titrate Rasilez to 300 mg Visit 4 (week 6). physician and nurse BP. ABPM and command lab exams (a week prior to visit 5) Visit 5 (12 weeks) physician and nurse BP SBPM data will be collected at visit 2,3,4 and 5.

Efficacy will be defined in terms of therapeutic goals expressed as target blood pressures according to WHO and ESH [ for SBPM and ABPM] criteria:

Office Blood Pressure: Diastolic blood pressure (DBP) ≤ 90 mmHg and Systolic blood pressure (SBP) ≤ 140 mmHg for non-diabetics or DBP≤ 80 mmHg and SBP≤ 130 mmHg for diabetics, respectively.

SBPM : DBP ≤ 85 mmHg and SBP ≤ 135 mmHg 24 h ABPM: DBP≤ 130/80 mmHg SBP≤ 130 mmHg, Awake DBP ≤ 85 mmHg, Awake SBP ≤ 135 mmHg Asleep DBP ≤70 mmHg, asleep SBP ≤ 70 mmHg. Effectiveness and Safety will also be evaluated taking into consideration patient compliance

Safety assessments:

Safety will be assessed by means of (S)AE reporting.

Study Type

Interventional

Enrollment (Actual)

50

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Israel
    • Hasharon Area
      • Hertsliyah, Hasharon Area, Israel
        • Clalit health services

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 80 years (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Essential hypertension at visit 1 defined as office blood pressure <140/90 mmHg and a 24 h ABPM >130/80 mmHg with a day time BP (extracted from the 24h ABPM) >135/85 mmHg
  2. Male and female
  3. Age 18-80
  4. Every patient that in the medical opinion of the treating physician is eligible for Rasilez treatment
  5. Willing to sign an informed consent

Exclusion Criteria:

  1. Use of more then 1 anti hypertensive medication at visit 1 (fixed combination is considered as two drugs)
  2. Use of ACEI or ARB at base line visit
  3. Pregnant women
  4. WOCB - (will follow the usual limitations)
  5. Use of certain medications (e.g. Cyclosporine, Verapamil, Quinidine)
  6. Uncontrolled DM (investigator decision)
  7. Any of the following in the last six months: MI, Stroke, CABG, PTCI
  8. Congestive HF requiring pharmacological treatment
  9. Renal Failure, defined as serum creatinine equal or great than 1.5 mg% [confirmed twice] or hyperkalemia defined as serum potassium equal or great that 5 meq/l [confirmed twice]
  10. Malignancy that required Chemotherapy in the last 3 years
  11. Any medical or none medical condition that in the eyes of the investigator will not allow the patient to complete the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: NA
  • Interventional Model: SINGLE_GROUP
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Aliskiren
only one arm with the experimental drug [aliskiren]
Drug: Aliskiren
150 mg during the first two weeks , 300 mg for another 10 weeks
Other Names:
  • Blood Pressure
  • Ambulatory Blood Pressure monitor
  • Self measured home blood pressure

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Percentage of patients with controlled blood pressure with office BP measurements, nurse measurements and SBPM, from baseline to week 12, compared and ABPM.
Time Frame: 12 weeks
12 weeks

Secondary Outcome Measures

Outcome Measure
Time Frame
Compare the SBP/DBP lowering efficacy of Rasilez treatment in patients with essential hypertension as measured by 4 different methods - 24h Ambulatory BP measurement, Office BP, Home BP and Nurse BP measurement.
Time Frame: 12 weeks
12 weeks
To assess patient adherence to treatment.
Time Frame: 2, 6 and 12 weeks
2, 6 and 12 weeks
To evaluate the safety profile of Rasilez treatment in patients with essential hypertension.
Time Frame: 2, 6 and 12 weeks
2, 6 and 12 weeks
Evaluate the antihypertensive effect of Rasilez in "real life", based on the 24h ABPM changes from base line to week 12.
Time Frame: 12 weeks
12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Meir Medical Center

Collaborators

Novartis Pharmaceuticals

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

March 1, 2010

Primary Completion (ACTUAL)

October 1, 2011

Study Completion (ACTUAL)

December 1, 2011

Study Registration Dates

First Submitted

February 1, 2010

First Submitted That Met QC Criteria

February 1, 2010

First Posted (ESTIMATE)

February 2, 2010

Study Record Updates

Last Update Posted (ESTIMATE)

January 11, 2017

Last Update Submitted That Met QC Criteria

January 10, 2017

Last Verified

May 1, 2011

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CSPP100AIL02T

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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