Cette page a été traduite automatiquement et l'exactitude de la traduction n'est pas garantie. Veuillez vous référer au version anglaise pour un texte source.

Effects of Titrated Oral Tolvaptan 15-60 mg Once Daily (QD) on Cognitive and Neurological Function in Elderly Hyponatremic Patients (INSIGHT)

26 avril 2011 mis à jour par: Otsuka Pharmaceutical Development & Commercialization, Inc.

A Pilot, Phase 3B, Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel Group Study of the Effects of Titrated Oral Tolvaptan 15, 30, or 60 mg QD on Cognitive and Neurological Function in Elderly Hyponatremic Patients

Demonstrate an improvement in the composite scores of validated neurocognitive tests in elderly subjects with chronic sub-clinical (i.e., asymptomatic) hyponatremia.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

Subjects will be randomized, with stratification by baseline sodium <130 or ≥ 130 mEq/L[mmol/L] to receive either tolvaptan 15 mg tablet or matching placebo tablet at doses of 15, 30 or 60 mg for 21 days. During this period, fluid restrictions should be loosened or suspended, until the subject's response to therapy can be evaluated, typically over the first few days of therapy. Fluid restriction may be reinstituted at any time in subjects whose sodium fails to improve or worsens with study therapy. A forced-titration up to 60 mg of study drug by day 3 to 7 will be based on the subject's serum sodium Subjects entering the study with a serum sodium concentration less than 130 mEq/L[mmol/L] may be fluid restricted if necessary at the discretion of the Investigator. Subjects should be monitored closely during the first 24 hours of treatment for dosing titration. The total dosing duration will be up to 21 days (plus 3 day treatment window). Subjects will return to the clinic on Day 22 (+3 days) for assessments and will complete a follow-up visit on Day 28 (+2 days).

Type d'étude

Interventionnel

Inscription (Réel)

57

Phase

  • Phase 3

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • États-Unis
    • California
      • Hawthorne, California, États-Unis, 90250
        • Sarah. S. Olelewe, MD
      • Vista, California, États-Unis, 92083
        • Progressive Clinical Research
    • Colorado
      • Colorado Springs, Colorado, États-Unis, 80907
        • Pikes Peak Cardiology
    • Florida
      • Largo, Florida, États-Unis, 33770
        • Innovative Research of West FL
      • Punta Gorda, Florida, États-Unis, 33950
        • Coastal Nephrology Assoc. Research Center
    • Georgia
      • Conyers, Georgia, États-Unis, 30094
        • Rockdale Medical Research Associates
    • Louisiana
      • Natchitoches, Louisiana, États-Unis, 71457
        • Otis Barnum, DO
    • North Dakota
      • Fargo, North Dakota, États-Unis, 58106
        • Lillestol Research, LLC
    • South Carolina
      • Columbia, South Carolina, États-Unis, 29201
        • Carolina Research Associates
    • Tennessee
      • Lebanon, Tennessee, États-Unis, 37087
        • Wayne O. Wells, MD
    • Texas
      • Houston, Texas, États-Unis, 77043
        • Memorial Clinical Associates
    • Virginia
      • Charlottesville, Virginia, États-Unis, 22908
        • Mitchell Rosner, MD

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

50 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • Women and men 50 years of age or older.
  • Serum Sodium ≥123 and ≤ 134 mEq/L [mmol/L]at screening and baseline.
  • Subjects with serum sodium concentrations ≥118 and ≤122 mEq/L[mmol/L] at screening and baseline may be entered into the trial based on consultation and approval from the study medical monitor.

Exclusion Criteria:

  • Conditions or history which may present a safety concern to the subject or their offspring or extreme susceptibility to hypotension with sudden fluid loss (aquaresis).
  • Hyponatremia that is acute, easily reversible, artifactual, or due to a condition not associated with vasopressin excess or likely to respond to aquaretic therapy.
  • Conditions associated with an independent imminent risk of morbidity and mortality.
  • Conditions which may confound the assessment of endpoints, history of poor compliance, participation in a clinical trial believed by the PI or Sponsor likely to confound endpoint assessments.
  • Conditions which may confound primary endpoints of cognitive function.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Double

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Comparateur placebo: 1
Placebo tablet given once a day for 21 days
Médicament: Placebo
Placebo tablet given once daily for 21 days
Comparateur actif: 2
Tolvaptan 15 mg-60 mg tablet given once a day for 21 days.
Médicament: Tolvaptan
15-60 mg oral tablet given once a day for 21 days.
Autres noms:
  • OPC-41061

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change From Baseline in the Neurocognitive Composite Score of Speed Domains (NCS-SD; Sum of All Correct Speed Domain Z-Scores)
Délai: baseline and Day 22
Change from baseline to Day 22 in sum of all speed domain Z-scores:Reaction Time (Simple=recognize "yes" 50 times;Choice=recognize "yes" or "no" 50 times;Digit Vigilance=match 45 digits);Psychomotor Speed (Morse Tapping=tap button for 30 seconds with right & left hands);Processing Speed (Rapid Visual Information Processing=detect consecutive sequences of 3 odd or 3 even digits;Numeric Working Memory=recognize numbers from series of 5 digits among 30;Word Recognition=remember 15 prior learned words from 30 total;results age-matched to healthy controls from Cognitive Drug Research normative data
baseline and Day 22

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change From Baseline to Day 22 in the Individual Neurocognitive Domains Included in the Primary Endpoint: Reaction Time in Computer Tests
Délai: baseline and Day 22
Change from baseline in the individual neurocognitive domains Z-score for Reaction Time in Computer Tests (simple reaction time test, choice reaction time test, digit vigilance test); ITT population
baseline and Day 22
Change From Baseline in the Individual Neurocognitive Domains Included in the Primary Endpoint: Psychomotor Speed Via Morse Tapping Test
Délai: baseline and Day 22
Change from baseline to Day 22 in the individual neurocognitive domains Z-score for Psychomotor Speed (mean tap rate of Morse tapping test); ITT population
baseline and Day 22
Change From Baseline in the Individual Neurocognitive Domains Included in the Primary Endpoint: Processing Speed of Rapid Visual Information Processing Test, Numeric Working Memory Test, and Word Recognition Test
Délai: baseline and Day 22
Change from baseline to Day 22 in the individual neurocognitive domains Z-score for Processing Speed of Rapid Visual Information Processing Test, Numeric Working Memory Test, and Word Recognition Test; ITT population
baseline and Day 22
Change From Baseline in Overall Neurocognitive Composite Score
Délai: baseline and Day 22
Change from Baseline to Day 22 in the overall Neurocognitive Composite Score (NCS)comprising the sum of 7 neurocognitive domain Z-scores (Reaction Time, Psychomotor Speed, Processing Speed, Continuity of Attention, Working Memory/Executive Functions, Quality of Episodic Verbal Memory, and Postural Stability); ITT population
baseline and Day 22
Change From Baseline in Gait Test (Timed Get-Up-and-Go Test)
Délai: baseline and Day 22
Change from baseline to Day 22 in Gait Test (Timed Get-Up-and-Go Test=time it takes for a seated subject to rise from a chair, walk 3 meters, walk around an object and return to sit in chair. Values: under 10 sec (no difficulties), 10 to 20 sec (starting to have balance difficulty), over 30 sec (at high risk for falls and dependent in most activities of daily living and mobility); test assesses risk to elderly subjects of falling and higher scores in seconds indicate higher risk of falling; ITT population
baseline and Day 22
Change From Baseline in Postural Stability Test
Délai: baseline and Day 22
Change from baseline to Day 22 in Postural Stability Test Z-score (This test measures gross motor control. The ability to stand upright without moving is assessed using the SWAY meter that is modeled on the Wright Ataxiameter. A cord from the meter is attached to the subject who is required to stand as still as possible with feet apart and eyes closed for 1 minute. The test is then repeated with eyes open for 1 minute. The outcomes of these tests are combined and measured as a movement Z-score. Higher result=better postural stability); ITT population
baseline and Day 22
Change From Baseline in Serum Sodium; ITT Population
Délai: Baseline and Day 22
Change from Baseline to Day 22 in Serum Sodium; ITT population
Baseline and Day 22
Number of Patients With Vital Sign Abnormalities: Blood Pressure
Délai: 28 days
Incidence of abnormal systolic & diastolic blood pressure values post-baseline (abnormal systolic values: >=180 mmHg + increase of >=20 mmHg, <= 90 mmHg + decrease >=20 mmHg; abnormal diastolic values: >=105 mmHg+increase of >=15 mmHg, <=50 mmHg + decrease of >= 15 mmHg)
28 days
Number of Patients With Vital Sign Abnormalities: Pulse Rate
Délai: 28 days
Incidence of abnormal pulse rate post-baseline [abnormal values: >=120 beats per minute (bpm) + increase of >=15 bpm; <=50 bpm + decrease of >=15 bpm]
28 days
Number of Patients With Vital Sign Abnormalities: Body Weight
Délai: 28 days
Incidence of clinically significant body weight change post-baseline (defined as change upward or downward of >=7%)
28 days
Number of Patients With Vital Sign Abnormalities: Body Temperature
Délai: 28 days
Incidence of potentially clinically significant changes in body temperature post-baseline (defined as an increase of >=1.1 to >=38.3 degrees Celsius)
28 days
Number of Patients With Hematology Laboratory Abnormalities: Hemoglobin
Délai: 28 days
Incidence of clinically significant hemoglobin abnormalities post-baseline (normal range=11.8-16.8 g/dL)
28 days
Number of Patients With Hematology Laboratory Abnormalities: Activated Partial Thromboplastin Time (aPTT)
Délai: 28 days
Incidence of potentially clinically significant Activated Partial Thromboplastin Time (aPTT) levels post-baseline (normal range=22-34 seconds)
28 days
Number of Patients With Hematology Laboratory Abnormalities: Lymphocytes
Délai: 28 days
Incidence of potentially clinically significant lymphocyte count post-baseline (normal range = 16-46%)
28 days
Number of Patients With Hematology Laboratory Abnormalities: Neutrophils
Délai: 28 days
Incidence of potentially clinically significant neutrophil count post-baseline (normal range=1.8-8 thousands/microliter)
28 days
Number of Patients With Serum Chemistry Laboratory Abnormalities: Blood Urea Nitrogen (BUN)
Délai: 28 days
Incidence of potentially clinically significant BUN levels post-baseline (normal range=7-30 mg/dL)
28 days
Number of Patients With Serum Chemistry Laboratory Abnormalities: Uric Acid
Délai: 28 days
Incidence of potentially clinically significant uric acid levels post-baseline (normal range=4-8.5 mg/dL)
28 days
Number of Patients With Serum Chemistry Laboratory Abnormalities: Cholesterol
Délai: 28 days
Incidence of potentially clinically significant cholesterol levels post-baseline (normal range=0-199 mg/dL)
28 days
Number of Patients With Serum Chemistry Laboratory Abnormalities: Glucose
Délai: 28 days
Incidence of potentially clinically significant glucose levels post-baseline (normal range=70-125 mg/dL)
28 days
Number of Patients With Serum Chemistry Laboratory Abnormalities: Magnesium
Délai: 28 days
Incidence of potentially clinically significant magnesium levels post-baseline (normal range=1.2-2 mEq/L)
28 days
Number of Patients With Electrocardiogram (ECG) Abnormalities: QT >500 Milliseconds (Msec)
Délai: 28 days
Incidence of potentially clinically significant ECG abnormalities (QT>500 msec) post-baseline
28 days
Number of Patients With Electrocardiogram (ECG) Abnormalities: QRS Interval
Délai: 28 days
Incidence of potentially clinically significant ECG abnormalities involving QRS interval (change > 100 msec)
28 days
Number of Patients With Electrocardiogram (ECG) Abnormalities: QTcB Increase 30-60 Msec
Délai: 28 days
Incidence of potentially clinically significant ECG abnormalities (QTcB increase 30-60 msec)
28 days
Number of Patients With Electrocardiogram (ECG) Abnormalities: QTcF Increase 30-60 Msec
Délai: 28 days
Incidence of potentially clinically significant ECG abnormalities (QTcF increase 30-60 msec post-baseline)
28 days
Number of Patients With Electrocardiogram (ECG) Abnormalities: ST Segment
Délai: 28 days
Incidence of potentially clinically significant ECG abnormalities: ST Segment
28 days
Number of Patients With Electrocardiogram (ECG) Abnormalities: T Wave
Délai: 28 days
Incidence of potentially clinically significant ECG abnormalities: T wave
28 days
Number of Patients With Electrocardiogram (ECG) Abnormalities: Right Bundle Branch Block (RBBB), Left Bundle Branch Block (LBBB), Myocardial Infarction (MI)
Délai: 28 days
Incidence of potentially clinically significant ECG abnormalities: Right bundle branch block (RBBB), Left bundle branch block (LBBB), myocardial infarction (MI)
28 days
Number of Patients With Electrocardiogram (ECG) Abnormalities: Arrhythmia
Délai: 28 days
Incidence of potentially clinically significant ECG abnormalities: arrhythmia
28 days

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Otsuka Pharmaceutical Development & Commercialization, Inc.

Collaborateurs

Otsuka Pharmaceutical Co., Ltd.

Les enquêteurs

  • Chercheur principal: Joseph Verbalis, MD, Georgetown University, Washington, DC, 20007 USA

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 août 2007

Achèvement primaire (Réel)

1 février 2009

Achèvement de l'étude (Réel)

1 mars 2009

Dates d'inscription aux études

Première soumission

25 octobre 2007

Première soumission répondant aux critères de contrôle qualité

26 octobre 2007

Première publication (Estimation)

29 octobre 2007

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

28 avril 2011

Dernière mise à jour soumise répondant aux critères de contrôle qualité

26 avril 2011

Dernière vérification

1 avril 2011

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • 156-04-246
  • INSIGHT

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

Essais cliniques sur Placebo

Rechercher des essais similaires

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

CROs by country

CROs in Mauritius

Conditions

Maladies rares

Interventions en matière de drogue

Compléments alimentaires

Commanditaire / collaborateurs

Emplacements

S'abonner