脊髄損傷のある低血圧者におけるノルエピネフリン前駆体ドロキシドパに対する用量反応
この研究の目的は、男性で 110/70 未満、女性で 100/70 未満の血圧として分類される低血圧、低血圧の被験者の血圧上昇における薬 Droxidopa (Northera) の有効性を判断することです。 最初の目的は、ドロキシドパに対して正常血圧反応を示す脊髄損傷 (SCI) 患者の割合を決定することです。 2 つ目は、ドロキシドパに対する高血圧反応を示す SCI 患者の割合を決定することです。 正常な血圧は、男性で 111 ~ 139、女性で 101 ~ 139 の範囲であり、高血圧は男性と女性で 140 よりも高いものです。
この研究は、ニューヨーク州マンハッタンのジェームズ J. ピーターズ VA メディカル センター (JJPVAMC) とマウント サイナイのアイカーン医科大学 (ISMMS) で行われます。
調査の概要
状態
状態
条件
条件
詳細な説明
研究の種類
研究の種類
入学 (実際)
入学
段階
段階
- フェーズ 4
連絡先と場所
研究連絡先
研究連絡先
- 名前:Matt T Maher, BS
- 電話番号:1706 718 584 9000
- メール:Matthew.Maher@va.gov
研究連絡先のバックアップ
- 名前:Matt T Maher, MS
- 電話番号:1706 718 584 9000
- メール:Matthew.Maher@va.gov
研究場所
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New York
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Bronx、New York、アメリカ、10468
- James J. Peters Veteran's Affair Medical Center
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New York、New York、アメリカ、10029
- The Icahn School of Medicine at Mount Sinai
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参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
説明
包含基準:
スタディ 1:
- 男性または女性、18 歳から 89 歳までの外傷性 SCI 患者。
SCI 被験者 (n=40):
- あらゆるレベルの怪我;
- -アメリカ脊髄損傷協会障害スケール(AIS)グレードのSCI;
- 人工呼吸器に依存しない
- 主に移動のために車椅子に依存しています。
- 損傷期間 < 1 年
低血圧:
- -男性の場合、収縮期血圧が110 mmHg未満および/または拡張期血圧が70 mmHg未満。
- -女性の場合、収縮期血圧が100 mmHg未満および/または拡張期血圧が70 mmHg未満。
- 第一言語は英語です。
インフォームドコンセントを提供できる
スタディ 2:
- 男性または女性、18 歳から 89 歳までの外傷性 SCI 患者。
SCI 被験者 (n=40):
- あらゆるレベルの怪我;
- AIS グレードの SCI;
- 人工呼吸器に依存しない
- 主に移動のために車椅子に依存
- 損傷期間 < 1 年
低血圧:
- -男性の場合、収縮期血圧が110 mmHg未満および/または拡張期血圧が70 mmHg未満。
- -女性の場合、収縮期血圧が100 mmHg未満および/または拡張期血圧が70 mmHg未満。
- 第一言語は英語です。
- インフォームドコンセントを提供できる
- 研究1中にドロキシドパに反応して正常血圧を示した.
除外基準:
- 現在の病気または感染症
頻繁または重度の自律神経反射異常のある人:
- 週に 3 回以上の症候性イベント
- 血圧≧140/90mmHg
- 重大な有害自覚症状の報告
- 高血圧症
- SCI以外の神経疾患(アルツハイマー病、認知症、脳卒中、多発性硬化症、パーキンソン病など)
- -てんかんまたは他の発作障害の病歴
- 外傷性脳損傷(TBI)の病歴
- 肝臓または腎臓病
- 尿の閉塞および/または弱い尿の流れを含む膀胱の問題。
- 統合失調症や双極性障害などの精神疾患の診断
- 既知の動脈疾患、心不全、房室ブロック、不整脈
- ドロキシドパ、アスプリン、ポリエチレンオキシド、ポリエチレングリコール、ヒドロキシプロピルセルロース、ブチル化ヒドロキシトルエン、ステアリン酸マグネシウム、ヒプロメロース、黄色三二酸化鉄、赤色三二酸化鉄に対するアレルギー
- 過去 30 日間の大手術
- 過去 6 か月間の違法薬物乱用
- 妊娠中
あなたの処方薬は、治験責任医師と研究スタッフによって審査されます。 現在、次のいずれかを治療するために薬を服用している場合は、治験責任医師に知らせてください。
d.うつ病、統合失調症、注意欠陥多動性障害(ADHD) e.痛み(オピオイド) f. 感染症または病気(抗生物質) g. 勃起不全(バイアグラ、シアリスなど) h. 過活動膀胱 i.高血圧または低血圧 j. 片頭痛 k. マラリア l.喘息
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:ダブル
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
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実験的:スタディ 1: Northera の用量最適化
被験者には、経口ドロキシドパが 200 mg から始まる非盲検の用量漸増法で投与されます。
投与量は、投与後60〜120分で記録された平均収縮期血圧(SBP)が男性で111〜139 mmHg、女性で101〜139 mmHgになるまで、その後の訪問で100 mgずつ上方調整され、持続的な上昇(連続30分以上) ) 着座 SBP ≥ 140/100 mmHg では、十分な SBP 反応なしで最大用量 800 mg に達します。
被験者は、最短で 1 日 (200 mg)、最長で 7 日 (800 mg) 試験所を訪れます。
着座心血管評価は、15分間隔で4時間監視および記録され、4時間の研究中、1時間ごとに副作用アンケートが実施されます。
各研究訪問には約 5 時間かかります。
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スタディ 1 は、200mg から 800mg までの用量範囲での Northera の用量最適化非盲検試験です。
他の名前:
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プラセボコンパレーター:スタディ 2: 盲検プラセボ & ノーセラ
参加者はその後、経口最適用量のノーセラ(ドロキシドパ)または一致するプラセボのいずれかを二重盲検法で投与され、60分間仰臥位のままになります。
被験者は、1) ECG、2) 上腕血圧、3) 指細動脈血圧、および 4) 脳血流速度 (CBFv) を含む計装のために車椅子のままになります。
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スタディ 1 は、200mg から 800mg までの用量範囲での Northera の用量最適化非盲検試験です。
他の名前:
研究 2 は、研究 1 で決定されたドロキシドパの個別化された最適用量を使用した盲検プラセボ対照試験です。
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この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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正常血圧範囲内の収縮BPの割合
時間枠:Droxidopaの投与から最大240分後
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男性の正常血圧収縮期血圧の割合(%)を決定する=(110-120 mmHg);および雌=(101-120 mmHg)ドロキシドパの投与後。
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Droxidopaの投与から最大240分後
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二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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仰pine亜共和性血圧
時間枠:ドロキシドパまたはプラセボの投与から60分以内
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SCIの低血圧参加者のプラセボと比較して、Droxidopaの投与後の仰pine病の収縮期血圧を測定する
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ドロキシドパまたはプラセボの投与から60分以内
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閉鎖性収縮期血圧
時間枠:ドロキシドパまたはプラセボの投与後60〜90分
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SCIの低血圧参加者のプラセボと比較して、ドロキシドパの投与後70度までのヘッドアップチルトに対する収縮期血圧応答を記録する。
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ドロキシドパまたはプラセボの投与後60〜90分
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歯膜脳脳血流
時間枠:ドロキシドパまたはプラセボの投与後60〜90分
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プラセボの投与後の中大脳動脈の脳血流速度を、ノースラの投与(ドロキシドパ)と比較する
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ドロキシドパまたはプラセボの投与後60〜90分
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協力者と研究者
協力者
協力者
捜査官
捜査官
- 主任研究者:Jill M Wecht, Ed.D、James J. Peter's VAMC
出版物と役立つリンク
一般刊行物
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