Efficacy and Safety Evaluating Study to Compare Kanarb (Fimasartan) and Cozaar® (Losartan) in Adult Patients With Grade I-II Arterial Hypertension

Open-label, Randomized, Multicenter, Efficacy and Safety Evaluating Study to Compare Kanarb (Fimasartan), Manufactured by Boryung Pharmaceutical Co., Ltd, Republic of Korea, Tablets 60/120 mg and Cozaar® (Losartan), Manufactured by MERCK SHARP & DOHME B.V., Netherlands, Tablet 50/100 mg in Adult Patients With Grade I-II Arterial Hypertension

Assess and compare the efficacy and safety of Kanarb (Fimasartan), manufactured by Boryung Pharmaceutical Co., Ltd, Republic of Korea, tablets 60/120 mg and Cozaar® (Losartan), manufactured by MERCK SHARP & DOHME B.V., Netherlands, tablet 50/100 mg in adult patients with Grade I-II arterial hypertension in 12 weeks of therapy

Study Overview

• Status: Completed
• Conditions: Arterial Hypertension
• Intervention / Treatment: Drug: Fimasartan; Drug: Losartan

Detailed Description

1. To evaluate efficacy of 12-week Kanarb (Fimasartan), manufactured by Boryung Pharmaceutical Co., Ltd, Republic of Korea, tablets 60/120 mg and Cozaar® (Losartan), manufactured by MERCK SHARP & DOHME B.V., Netherlands, tablet 50/100 mg in adult patients with Grade I-II arterial hypertension.
2. To evaluate safety of 12-week Kanarb (Fimasartan), manufactured by Boryung Pharmaceutical Co., Ltd, Republic of Korea, tablets 60/120 mg and Cozaar® (Losartan), manufactured by MERCK SHARP & DOHME B.V., Netherlands, tablet 50/100 mg in adult patients with Grade I-II arterial hypertension.
3. Assess the pharmacokinetics parameters of Kanarb (Fimasartan), manufactured by Boryung Pharmaceutical Co., Ltd, Republic of Korea in adult patients with arterial hypertension I-II stage after a single dose.

Starting dose of Kanarb (Fimasartan), manufactured by Boryung Pharmaceutical Co., Ltd, Republic of Korea is 60 mg, orally, once a day in the morning.

The planned study duration for each subject is 18 weeks maximum:

The screening period could takes up to 2 weeks (including the 1-week "wash-out" period ) - the screening period duration depends on the prior anti-hypertensive therapy:

• "naive" subjects who never received therapy (which must be reflected in the source documents), may be randomized after completion of all screening procedures;
• Subjects receiving anti-hypertensive therapy which may be discontinued without prior dose reduction must undergo a 7 days "wash-out" period, so the screening period will take at least 7 days;
• Subjects, receiving anti-hypertensive therapy which requires dose reduction before discontinuation must undergo the 7 days "wash-out" period after the last dose administration, so the screening period will consist of dose reduction period and a "wash-out" period.

Treatment period - 12 weeks. Follow-up period - 4 weeks. The subjects will visit the clinical site every 4 weeks to measure ABP. The dose will be doubled in case if SBP ≥140 mmHg or DBP ≥90 mmHg at Visit 3 (Day 28) or at Visit 4 (Day 56).

If necessary, the dose of the study drug may be increased based on the assessment of patient's condition performed at the phone contact (Day14±3). Patient may be called for an unscheduled visit for treatment adjustment (decided individually, with possibility of dose titration as per investigator's judgment, indicated in source documents).

When possibilities are, the patient should be administrated by the study medication at the same time in the morning. Governing conditions for defining the time of the drug administration is the subject comfort and the time of its visits the research center.

If laboratory tests are scheduled, a patient should come to the research center fasting (food is prohibited for 8 hours before the visit).

All of the clinical evaluations are conducted on the next morning after taking the medication. On the visit day a patient comes to the research center not taking the drug, and after all the planned procedures are conducted the patient is administrated by the drug.

• Study Type: Interventional
• Enrollment (Actual): 179
• Phase: Phase 3

Contacts and Locations

Study Locations

• Russian Federation
  • Moscow, Russian Federation
    • Federal State Institution "Russian Cardiology Research and Production Complex" of the Ministry of Health and Social Development of the Russian Federation (FSI "Cardiology" Russian Healthcare Ministry)
  • Moscow, Russian Federation
    • Moscow Health Department "City Clinical Hospital № 81"
  • Moscow, Russian Federation
    • State Research Center for Preventive Medicine of Ministry of Health of the Russian gederation
  • Pushkin, Russian Federation
    • St. Petersburg State health agency "City Hospital number 38 it. NA Semashko "
  • St. Petersburg, Russian Federation, 190000
    • St. Petersburg State healthcare Institution "City Hospital number 28" "Maximilianovskaya"
  • St. Petersburg, Russian Federation
    • Clinical Hospital n. a. St. Luka
  • St. Petersburg, Russian Federation
    • Federal Almazov Medical Research Centre
  • St. Petersburg, Russian Federation
    • St. Petersburg State Healthcare Institution 'Diagnostic Centre #85'
  • St. Petersburg, Russian Federation
    • St. Petersburg State Institution of Health "City Hospital № 15"
  • St. Petersburg, Russian Federation
    • St. Petersburg State Institution of Healthcare "Pokrovskaya City Hospital"
  • St. Petersburg, Russian Federation
    • State Budget Education Institution of Higher Professional Education "North-Western State Medical University named after I.I. Mechnikov" on base St. Petersburg State Institution of Healthcare "Pokrovskaya City Hospital"
  • St. Petersburg, Russian Federation
    • State Budget Education Institution of Higher Professional Education "North-Western State Medical University named after I.I. Mechnikov", the department faculty and hospital care, court number 5
  • Troitsk, Russian Federation
    • Troitsk City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Subjects of both sex aged 18-75 inclusively.
2. Subjects who signed their written Informed Consent for participation in the study and willing to adhere to all Protocol procedures.
3. Subjects with documented diagnosis of grade I-II primary arterial hypertension within at least 3 months before screening.

4. Systolic blood pressure (SBP) (when seated) at Screening (Day -14)

   • For subjects administered with anti-hypertensive therapy: SBP ≤ 179 Hg
   • For subjects receiving no anti-hypertensive therapy (so called 'naïve' patients): 140≥SBP ≤179.
5. As per investigator's judgment, subjects with controlled arterial hypertension must benefit from the therapy switch to Kanarb (Fimasartan), manufactured by Boryung Pharmaceutical Co., Ltd, Republic of Korea, tablets 60/120 mg and Cozaar® (Losartan), manufactured by MERCK SHARP & DOHME B.V., Netherlands, .
6. For subjects administered with anti-hypertensive drugs: the anti-hypertensive drug may be safely cancelled during the "wash-out" period according to the investigator's judgment.
7. For women of child-bearing potential: negative urine pregnancy test at screening (Day -14). 8. Systolic blood pressure (SBP) (when seated) at Randomization (Day 0) ≥140 mmHg and ≤179 mmHg.

9. For women of child-bearing potential: negative urine pregnancy test at Randomization (Day 0)

Exclusion Criteria:

1. Grade III Arterial Hypertension.
2. Arterial hypotension (SPB ≤100 mm Hg) at Screening (Day -14) and/or Randomization (Day 0).
3. Subjects needing treatment with more than one anti-hypertensive drug (more than one active substance, including complex drugs).
4. Secondary (symptomatic) arterial hypertension.
5. Known bilateral renal arterial stenosis or unilateral renal arterial stenosis.
6. Hyperpotassemia >5,0 mmol/l (as per blood biochemistry results at Screening).
7. Primary hyperaldosteronism.
8. Known hypersensitivity to angiotensin-II receptors antagonists or any other study drug or comparator component.
9. Contraindications for use of angiotensin-II receptors antagonists.
10. Myocardial infarction and or unstable angina, and/or acute cerebrovascular accident/transient ischemic attack, and/or percutaneous coronary intervention, and/or coronary arterial bypass graft, acute coronary arteries involvement, and/or obliterative vascular atherosclerosis of low extremities, and/or grade III and IV retinopathy in anamnesis.
11. Clinically significant cardiac valves damage.
12. Cardiomyopathies
13. Chronic Heart failure (CHF) (except for CHF FC I NYHA).
14. Creatinine clearance less than 60 ml/min/1.73m2 calculated by Cockroft-Gault formula.
15. Known moderate to severe hepatic insufficiency and/or transaminase increase: AST and/or ALT ≥2*ULN.
16. History of infections (HIV, hepatitis B or C, syphilis).
17. Uncontrolled Diabetes mellitus, Glycosylated hemoglobin level (HbA1c) >7%.
18. Severe systemic diseases, such as gastro-intestinal tract diseases, autoimmune disorders, blood disorders and other conditions which may affect on the study drugs' absorption, distribution and and excretion.
19. Clinically significant abnormalities of laboratory parameters.
20. Drug or alcohol addiction, psychiatric disorders.
21. Medical history of oncological disease within 5 years before screening.
22. Subjects with biliary tracts obstruction.
23. Subjects with genetic disorders, such as galactose intolerance, congenital lactase insufficiency and glucose-galaclose malabsorption syndrome.
24. Any other acute disease or progression and/or decompensation at the moment of enrollment
25. Necessity to administer or administration of prohibited concomitant drugs from the "List of Prohibited Drugs" within 14 days before enrollment
26. Pregnancy or breast-feeding period; fertile women not using adequate contraception methods
27. Participation in another clinical trial within 3 months before Screening.
28. Other medical or psychiatric conditions or lab abnormalities that may increase potential risk associated with study participation and IP administration, or that may affect study results interpretation and as per investigator's judgment, make the subject ineligible.
29. Study site personnel or Sponsor's representatives immediately involved in the study.
30. Subjects, excluded from the study may not be included in it again.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Kanarb (Fimasartan); 88 subjects will receive Kanarb (Fimasartan), manufactured by Boryung Pharmaceutical Co., Ltd, Republic of Korea, tablets 60/120 mg for 12 weeks	Drug: Fimasartan; Starting dose of Kanarb (Fimasartan) is 60 mg, orally, once a day in the morning. The subjects will visit the clinical site every 4 weeks to measure Arterial blood pressure (ABP). The dose will be doubled in case if SBP ≥140 mmHg or DBP ≥90 mmHg at Visit 3 (Day 28) or at Visit 4 (Day 56). If necessary, the dose of the study drug may be increased based on the assessment of patient's condition performed at the phone contact (Day14±3). Patient may be called for an unscheduled visit for treatment adjustment (decided individually, with possibility of dose titration as per investigator's judgment, indicated in source documents). When possibilities are, the patient should be administrated by the study medication at the same time in the morning.; Other Names: Kanarb
Active Comparator: Cozaar® (Losartan); 88 subjects will receive Cozaar® (Losartan), manufactured by MERCK SHARP & DOHME B.V., Netherlands, tablets 50/100 mg for 12 weeks	Drug: Losartan; Cozaar® (Losartan), manufactured by MERCK SHARP & DOHME B.V., Netherlands, tablets 50/100 mg; Other Names: Cozaar®

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Systolic Blood Pressure (SBP) After 12 Weeks of Treatment	The value of SBP (seated) to be registered was mean of the 3 measurements performed with interval no less than 1 minute using the manual (mercury or mechanic) tonometer after 5 minutes rest. "Change" was calculated as (Value of SBP at week 12 minus Value of SBP at baseline).	Baseline and week 12 of treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Diastolic Blood Pressure (DBP) After 4 Weeks of Treatment	The value of DBP (seated) to be registered was mean of the 3 measurements performed with interval no less than 1 minute using the manual (mercury or mechanic) tonometer after 5 minutes rest. "Change" was calculated as (Value of DBP at week 4 minus Value of SBP at baseline).	Baseline and week 4 of treatment
Change in DBP After 8 Weeks of Treatment	The value of DBP (seated) to be registered was mean of the 3 measurements performed with interval no less than 1 minute using the manual (mercury or mechanic) tonometer after 5 minutes rest. "Change" was calculated as (Value of DBP at week 8 minus Value of SBP at baseline).	Baseline and week 8 of treatment
Change in DBP After 12 Weeks of Treatment	The value of DBP (seated) to be registered was mean of the 3 measurements performed with interval no less than 1 minute using the manual (mercury or mechanic) tonometer after 5 minutes rest. "Change" was calculated as (Value of DBP at week 12 minus Value of SBP at baseline).	Baseline and week 12 of treatment
Change in SBP After 4 Weeks of Treatment	The value of SBP (seated) to be registered was mean of the 3 measurements performed with interval no less than 1 minute using the manual (mercury or mechanic) tonometer after 5 minutes rest. "Change" was calculated as (Value of SBP at week 4 minus Value of SBP at baseline).	Baseline and week 4 of treatment
Change in SBP After 8 Weeks of Treatment	The value of SBP( seated) to be registered was mean of the 3 measurements performed with interval no less than 1 minute using the manual (mercury or mechanic) tonometer after 5 minutes rest. "Change" was calculated as (Value of SBP at week 8 minus Value of SBP at baseline).	Baseline and week 8 of treatment
Number of Subjects Who Responded on Therapy	The subject will be considered a responder if SBP (when seated) <140 mmHg or SBP decrease is >10% from baseline.	Week 12 of treatment

Collaborators and Investigators

• Sponsor: R-Pharm
• Collaborators: Covance; Boryung Pharmaceutical Co., Ltd

Study record dates

Study Major Dates

• Study Start: May 1, 2014
• Primary Completion (Actual): August 1, 2015
• Study Completion (Actual): August 1, 2015

Study Registration Dates

• First Submitted: September 22, 2014
• First Submitted That Met QC Criteria: September 22, 2014
• First Posted (Estimate): September 25, 2014

Study Record Updates

• Last Update Posted (Actual): May 6, 2019
• Last Update Submitted That Met QC Criteria: February 5, 2019
• Last Verified: February 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Hypertension; Molecular Mechanisms of Pharmacological Action; Anti-Arrhythmia Agents; Antihypertensive Agents; Angiotensin II Type 1 Receptor Blockers; Angiotensin Receptor Antagonists; Losartan
• Other Study ID Numbers: CC09042014