Study of Nifedipine GITS and Candesartan Combination Compared to Monotherapy in Patients With Essential Hypertension (DISTINCT)

April 14, 2017 updated by: Bayer

A Multicenter, Multifactorial, Randomized, Double-Blind, Placebo-Controlled Dose-Finding Study of Nifedipine GITS and Candesartan in Combination Compared to Monotherapy in Adult Patients With Essential Hypertension

The purpose of this study is to determine the blood pressure lowering responses of various dose combinations of nifedipine GITS and candesartan as compared to treatment with each component on their own (monotherapy) and placebo (a look-alike tablet without active ingredient). The drugs - nifedipine GITS and candesartan - which are being investigated are currently approved for use in patients with essential hypertension alone or together with other antihypertensive drugs (combination therapy), but the optimal dose of nifedipine GITS and candesartan used together in the treatment of essential hypertension has not been established yet. In this study patients will be treated with various doses of nifedipine GITS and/or candesartan or placebo. These different regimens will be administered once a day and will be assessed based on their blood pressure lowering effects (mean sitting diastolic blood pressure) in subjects with mild to moderate essential hypertension.

Study Overview

Study Type

Interventional

Enrollment (Actual)

1381

Phase

  • Phase 2

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

      • Corrientes, Argentina, 3400
      • Córdoba, Argentina, 5000
      • Córdoba, Argentina, X5002AOQ
      • Santa Fe, Argentina, 3000
    • Buenos Aires
      • Bahía Blanca, Buenos Aires, Argentina, 8000
      • Quilmes, Buenos Aires, Argentina
      • Zárate, Buenos Aires, Argentina, B2800DGH
    • Ciudad Auton. de Buenos Aires
      • Buenos Aires, Ciudad Auton. de Buenos Aires, Argentina, C1280AEB
      • Buenos Aires, Ciudad Auton. de Buenos Aires, Argentina, C1425AWC
      • Buenos Aires, Ciudad Auton. de Buenos Aires, Argentina, 1405
      • Buenos Aires, Ciudad Auton. de Buenos Aires, Argentina, C1425DES
      • Buenos Aires, Ciudad Auton. de Buenos Aires, Argentina, C1430AAQ
      • Buenos Aires, Ciudad Auton. de Buenos Aires, Argentina, C1440AAD
    • Santa Fe
      • Rosario, Santa Fe, Argentina, 2000
      • De Pinte, Belgium, 9840
      • Deurne, Belgium, 2100
      • HAM, Belgium, 3545
    • Oost-Vlaanderen
      • Wetteren, Oost-Vlaanderen, Belgium, 9230
      • Rio de Janeiro, Brazil, 22271-100
      • Sao Paulo, Brazil, 01244-030
    • Ceará
      • Fortaleza, Ceará, Brazil, 60120-021
    • Distrito Federal
      • Brasília, Distrito Federal, Brazil, 71265 009
    • Goiás
      • Goiania, Goiás, Brazil, 74605-050
    • Sao Paulo
      • Campinas, Sao Paulo, Brazil, 13010-001
      • Campinas, Sao Paulo, Brazil, 13060904
      • São Paulo, Sao Paulo, Brazil, 04025-011
    • British Columbia
      • Langley, British Columbia, Canada, V3A 4H9
    • Newfoundland and Labrador
      • St. John's, Newfoundland and Labrador, Canada, A1E 2E2
      • St. John's, Newfoundland and Labrador, Canada, A1A 3R5
    • Ontario
      • Brampton, Ontario, Canada, L6T 0G1
      • Corunna, Ontario, Canada, N0N 1G0
      • Downsview, Ontario, Canada, M3J 1N2
      • Etobicoke, Ontario, Canada, M8V 3X8
      • London, Ontario, Canada, N5W 6A2
      • London, Ontario, Canada, N5Y 5K7
      • Newmarket, Ontario, Canada, L3Y 5G8
      • Sarnia, Ontario, Canada, N7T 4X3
      • Strathroy, Ontario, Canada, N7G 1Y7
      • Toronto, Ontario, Canada, M9W 4L6
      • Toronto, Ontario, Canada, M9V 4B4
    • Quebec
      • Montreal, Quebec, Canada, H4N 2W2
      • Mercato San Severino, Italy, 84085
    • Abruzzo
      • Chieti, Abruzzo, Italy, 66013
    • Emilia-Romagna
      • Bologna, Emilia-Romagna, Italy, 40138
    • Friuli-Venezia Giulia
      • Trieste, Friuli-Venezia Giulia, Italy, 34149
    • Lombardia
      • Milano, Lombardia, Italy, 20132
      • Pavia, Lombardia, Italy, 27100
    • Sardegna
      • Sassari, Sardegna, Italy, 07100
    • Toscana
      • Pisa, Toscana, Italy, 56124
    • Umbria
      • Perugia, Umbria, Italy, 06129
      • Busan, Korea, Republic of, 602-793
      • Chungchungbuk-do, Korea, Republic of, 361-711
      • Seoul, Korea, Republic of, 110-744
      • Seoul, Korea, Republic of, 120-752
      • Seoul, Korea, Republic of, 133-792
      • Seoul, Korea, Republic of, 150-950
      • Seoul, Korea, Republic of, 156-707
    • Daejeon Gwang''yeogsi
      • Daejeon, Daejeon Gwang''yeogsi, Korea, Republic of, 301-723
    • Gang''weondo
      • Wonju-si, Gang''weondo, Korea, Republic of, 220-701
    • Gyeonggido
      • Anyang-si, Gyeonggido, Korea, Republic of, 431-070
      • Goyang-Si, Gyeonggido, Korea, Republic of, 410-719
      • Goyang-si, Gyeonggido, Korea, Republic of, 410-773
      • Goyang-si, Gyeonggido, Korea, Republic of, 411-706
      • Goyang-si, Gyeonggido, Korea, Republic of, 412-270
      • Uijeongbu, Gyeonggido, Korea, Republic of, 480-130
    • Seoul Teugbyeolsi
      • Seoul, Seoul Teugbyeolsi, Korea, Republic of, 152-703
      • Seoul, Seoul Teugbyeolsi, Korea, Republic of, 150-713
      • Seoul, Seoul Teugbyeolsi, Korea, Republic of, 135-720
      • Seoul, Seoul Teugbyeolsi, Korea, Republic of, 156-755
      • Seoul, Seoul Teugbyeolsi, Korea, Republic of, 158 710
      • Alytus, Lithuania, LT-62381
      • Kaunas, Lithuania, LT-50009
      • Kaunas, Lithuania, LT-49387
      • Vilnius, Lithuania, LT-08661
      • Moscow, Russian Federation, 125284
      • Moscow, Russian Federation, 117997
      • Moscow, Russian Federation, 119048
      • Moscow, Russian Federation, 115432
      • Moscow, Russian Federation, 119415
      • Smolensk, Russian Federation, 214019
      • St Petersburg, Russian Federation, 198013
      • St. Petersburg, Russian Federation, 197022
      • St. Petersburg, Russian Federation, 195271
      • St. Petersburg, Russian Federation, 196247
      • St. Petersburg, Russian Federation, 199106
      • St. Petersburg, Russian Federation, 197341
      • St. Petersburg, Russian Federation, 195112
      • St. Petersburg, Russian Federation, 198205
    • Eastern Cape
      • Port Elizabeth, Eastern Cape, South Africa, 6014
    • Gauteng
      • Johannesburg, Gauteng, South Africa
      • Petoria, Gauteng, South Africa
      • Roodepoort, Gauteng, South Africa, 1724
    • KwaZulu Natal
      • Durban, KwaZulu Natal, South Africa, 4037
    • Mpumalanga
      • Witbank, Mpumalanga, South Africa, 1035
    • Western Cape
      • Somerset West, Western Cape, South Africa, 7130
      • Stellenbosch, Western Cape, South Africa, 7505
      • Barcelona, Spain, 08036
      • Granada, Spain, 18012
      • Huelva, Spain, 21003
      • Valencia, Spain, 46006
    • A Coruña
      • Santiago de Compostela, A Coruña, Spain, 15706
    • Alicante
      • Benidorm, Alicante, Spain, 03503
      • Petrer, Alicante, Spain, 03610
    • Asturias
      • Oviedo, Asturias, Spain, 33013
    • Barcelona
      • Hostalets de Balenyà, Barcelona, Spain, 08550
    • Girona
      • Peralada, Girona, Spain, 17491
      • Dnipropetrovsk, Ukraine, 49060
      • Kharkiv, Ukraine, 61176
      • Kiev, Ukraine, 02660
      • Kiev, Ukraine, 01151
      • Kiev, Ukraine, 03680
      • Kiev, Ukraine, 02 091
      • Kiev, Ukraine, 01 151
      • Vinnitsa, Ukraine, 2108
      • Zaporizhzhya, Ukraine, 69118
      • Zhytomyr, Ukraine, 10002
      • Bath, United Kingdom, BA11 2FH
      • Bath, United Kingdom, BA2 4JT
    • Avon
      • Bath, Avon, United Kingdom, BA2 4BY
    • Cornwall
      • Fowey, Cornwall, United Kingdom, PL23 1DT
      • Penzance, Cornwall, United Kingdom, TR18 4JH
      • Penzance, Cornwall, United Kingdom, TR19 7HX
      • St Austell, Cornwall, United Kingdom, PL26 7RL
    • Derbyshire
      • Chesterfield, Derbyshire, United Kingdom, S40 4AA
    • Glasgow City
      • Glasgow, Glasgow City, United Kingdom, G20 0XA
      • Glasgow, Glasgow City, United Kingdom, G20 7LR
    • Lancashire
      • Blackpool, Lancashire, United Kingdom, FY3 7EN
    • Somerset
      • Bath, Somerset, United Kingdom, BA3 2UH
    • Surrey
      • Addlestone, Surrey, United Kingdom, KT15 2BH
    • Warwickshire
      • Coventry, Warwickshire, United Kingdom, CV6 4DD
      • Leamington Spa, Warwickshire, United Kingdom, CV32 4RA
    • Wiltshire
      • Chippenham, Wiltshire, United Kingdom, SN15 2SB
      • Trowbridge, Wiltshire, United Kingdom, BA14 8QA
      • Westbury, Wiltshire, United Kingdom, BA13 3JD
    • Alabama
      • Mobile, Alabama, United States, 36617
    • California
      • Los Angeles, California, United States, 90057
    • Florida
      • Coral Gables, Florida, United States, 33114-4192
      • Deerfield Beach, Florida, United States, 33321
      • Deerfield Beach, Florida, United States, 33441
      • Ft. Lauderdale, Florida, United States, 33309
      • Jacksonville, Florida, United States, 32216
      • West Palm Beach, Florida, United States, 33409
    • Georgia
      • Atlanta, Georgia, United States, 30338
    • Indiana
      • Valparaiso, Indiana, United States, 46383
    • North Carolina
      • Charlotte, North Carolina, United States, 28209
      • Harrisburg, North Carolina, United States, 28075
      • Raleigh, North Carolina, United States, 27609
      • Salisbury, North Carolina, United States, 28144
    • Ohio
      • Cincinnati, Ohio, United States, 45224
    • Pennsylvania
      • Philadelphia, Pennsylvania, United States, 19142
    • South Carolina
      • Greenville, South Carolina, United States, 29615
      • Mt. Pleasant, South Carolina, United States, 29464
    • Texas
      • Dallas, Texas, United States, 75230
      • San Antonio, Texas, United States, 78205
    • Utah
      • Salt Lake City, Utah, United States, 84121
      • Salt Lake City, Utah, United States, 84109
    • Wisconsin
      • Kenosha, Wisconsin, United States, 53142

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 and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Male and female subjects 18 years or older. Female subjects must be either post-menopausal for one year, surgically sterile, or using an effective contraceptive method. Hormonal contraceptive use is disallowed.
  • Subjects must have mild to moderate essential hypertension (Grade 1 and 2 WHO classifications) as measured by calibrated standard sphygmomanometer. (MSDBP of ≥90 mmHg and < 110 mmHg at Visit 1 (placebo run-in), and MSDBP of ≥95 mmHg and < 110 mmHg at visit 2 (randomization)
  • Subjects must have an absolute difference in their MSDBP of less than 10 mmHg between Visit 1 (placebo run- in) and Visit 2 (randomization).

Exclusion Criteria:

  • Severe hypertension (Grade 3 WHO classification; MSDBP ≥110 mmHg and/or MSSBP ≥ 180 mmHg)
  • Inability to washout of antihypertensive drugs (even if prescribed for another indication) safely for a period of 14 weeks.
  • History of hypertensive retinopathy - known Keith-Wagener Grade III or IV
  • History of hypertensive encephalopathy
  • Cerebrovascular ischemic event (stroke, transient ischemic attack [TIA])within the previous 12 months
  • History of intracerebral hemorrhage or subarachnoid hemorrhage
  • Evidence of secondary hypertension such as coarchation of the aorta, pheochromocytoms, hypersaldosteronism, etc.
  • Type I diabetes mellitus (DM) or poorly controlled DM Type II as evidenced by a glycosylated hemoglobin [HbA1C] of greater than 9% on visit 1.
  • Allergies or known intolerance to one of the investigational drugs/drug class or to one of their ingredients
  • Any history of heart failure, New York Heart Association (NYHA) classification III or IV
  • Severe coronary heart disease as manifest by a history of myocardial infarction or unstable angina in the last 6 months prior to visit 1.
  • Clinically significant cardiac valvular disease
  • History of malignancy in the last 5 years, excluding basal or skin cancer
  • Uncorrected hypokalemia or hyperkalemia: potassium outside 3.0-5.0 mmol/L
  • Surgical or medical conditions that might alter the metabolism, excretion or distribution or absorption of any drug

    1. Gastrointestinal disease or surgery resulting in the potential for malabsorption
    2. Severe gastrointestinal tract narrowing; kock pouch (ileostomy after proctocolectomy)
    3. Cholestasis or biliary obstruction or history of pancreatic injury or clinical significant increase of lipase, amylase, or bilirubin.
    4. Liver disease or AST/ALT levels >3 x ULN
    5. Renal insufficiency, defined as eGFR of < 50 mL/min (computed using the Cockroft-Gault formula), or on hemodialysis
  • Investigation trial participation with receipt of investigational study drug within the last month
  • Previous assignment to treatment in this study
  • Female subjects who are pregnant or lactating.
  • Subjects who have night employment (night shift).
  • Subjects with an aortic aneurysm that, in the opinion of the investigator, will be unsuitable to be enrolled in the study.
  • Thought by the investigator for any reason to be unsuitable for participation in a clinical study
  • Systemic use of known cytochrome P450-3A4 inhibitors (e.g cimetidine, anti-human immunodeficiency virus [HIV] protease inhibitors e.g. ritonavir, azole anti-mycotics eg. ketoconazole,) or inducers (e.g rifampicin, anti-epileptic drugs eg. phenytoin, carbamazepine and phenobarbitone) or some P450-3A4 substrates (e.g quinidine, digoxin, tacrolimus)
  • Present severe rhythm or conduction disorder:
  • Atrial fibrillation
  • Second or third degree heart block without a pacemaker.
  • Baseline QTc >450 msec
  • History of non-compliance, alcoholism or drug abuse that in the opinion of the investigator will compromise successful completion of the study.
  • If differences greater than 20 mmHg for SBP and 10 mmHg for DBP are present on 3 consecutive BP readings, the subject should be excluded from 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: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Nifedipine GITS 20 mg
Subjects received 20 mg of nifedipine GITS (single tablet) monotherapy once daily for 8 weeks along with 2 placebo tablets and 1 placebo capsule
20 mg nifedipine as tablet
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
Experimental: Nifedipine GITS 30 mg
Subjects received 30 mg of nifedipine GITS (single tablet) monotherapy once daily for 8 weeks along with 2 placebo tablets and 1 placebo capsule
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
30 mg nifedipine as tablet
Experimental: Nifedipine GITS 60 mg
Subjects received 60 mg of nifedipine GITS (single tablet) monotherapy once daily for 8 weeks along with 2 placebo tablets and 1 placebo capsule
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
60 mg nifedipine as tablet
Experimental: Candesartan cilexetil 4 mg
Subjects received 4 mg of candesartan cilexetil (single capsule) monotherapy once daily for 8 weeks along with 3 placebo tablets
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
4 mg of candesartan as capsule
Experimental: Candesartan cilexetil 8 mg
Subjects received 8 mg of candesartan cilexetil (single capsule) monotherapy once daily for 8 weeks along with 3 placebo tablets
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
8 mg candesartan as capsule
Experimental: Candesartan cilexetil 16 mg
Subjects received 16 mg of candesartan cilexetil (single capsule) monotherapy once daily for 8 weeks along with 3 placebo tablets
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
16 mg of candesartan as capsule
Experimental: Candesartan cilexetil 32 mg
Subjects received 32 mg of candesartan cilexetil (single capsule) monotherapy once daily for 8 weeks along with 3 placebo tablets
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
32 mg of candesartan as capsule
Experimental: Nifedipine/candesartan 20/4 mg
Subjects received the combination of 20 mg of nifedipine GITS/4 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
20 mg nifedipine as tablet
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
4 mg of candesartan as capsule
Experimental: Nifedipine/candesartan 20/8 mg
Subjects received the combination of 20 mg of nifedipine GITS/8 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
20 mg nifedipine as tablet
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
8 mg candesartan as capsule
Experimental: Nifedipine/candesartan 20/16 mg
Subjects received the combination of 20 mg of nifedipine GITS/16 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
20 mg nifedipine as tablet
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
16 mg of candesartan as capsule
Experimental: Nifedipine/candesartan 30/8 mg
Subjects received the combination of 30 mg of nifedipine GITS/8 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
30 mg nifedipine as tablet
8 mg candesartan as capsule
Experimental: Nifedipine/candesartan 30/16 mg
Subjects received the combination of 30 mg of nifedipine GITS/16 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
30 mg nifedipine as tablet
16 mg of candesartan as capsule
Experimental: Nifedipine/candesartan 30/32 mg
Subjects received the combination of 30 mg of nifedipine GITS/32 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
30 mg nifedipine as tablet
32 mg of candesartan as capsule
Experimental: Nifedipine/candesartan 60/16 mg
Subjects received the combination of 60 mg of nifedipine GITS/16 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
60 mg nifedipine as tablet
16 mg of candesartan as capsule
Experimental: Nifedipine/candesartan 60/32 mg
Subjects received the combination of 60 mg of nifedipine GITS/32 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
60 mg nifedipine as tablet
32 mg of candesartan as capsule
Placebo Comparator: Placebo
Subjects received placebo (3 tablets and 1 capsule) once daily for 8 weeks
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
The primary efficacy variable is the change from baseline in mean seated diastolic blood pressure (MSDBP) at Week 8
Time Frame: Baseline taken at Visit 1; primary outcome variable assesed at 8 weeks
Baseline taken at Visit 1; primary outcome variable assesed at 8 weeks

Secondary Outcome Measures

Outcome Measure
Time Frame
Change in mean seated systolic blood pressure (MSSBP) at Week 8
Time Frame: 8 weeks
8 weeks
Control rate at Week 8
Time Frame: 8 weeks
8 weeks
Response rate at Week 8
Time Frame: 8 weeks
8 weeks
Peripheral Edema
Time Frame: 8 weeks
8 weeks
Time to achieve first BP control
Time Frame: 8 weeks
8 weeks

Collaborators and Investigators

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

Sponsor

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.

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

April 1, 2011

Primary Completion (Actual)

May 1, 2012

Study Completion (Actual)

May 1, 2012

Study Registration Dates

First Submitted

February 24, 2011

First Submitted That Met QC Criteria

February 24, 2011

First Posted (Estimate)

February 25, 2011

Study Record Updates

Last Update Posted (Actual)

April 18, 2017

Last Update Submitted That Met QC Criteria

April 14, 2017

Last Verified

April 1, 2017

More Information

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.

Clinical Trials on Hypertension, Essential

Clinical Trials on Nifedipine GITS (Adalat, BAYA1040), 20 mg

3
Subscribe