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

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.

調査の概要

詳細な説明

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).

研究の種類

介入

入学 (実際)

57

段階

  • フェーズ 3

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

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

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

50年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

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.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

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

武器と介入

参加者グループ / アーム
介入・治療
プラセボコンパレーター:1
Placebo tablet given once a day for 21 days
Placebo tablet given once daily for 21 days
アクティブコンパレータ:2
Tolvaptan 15 mg-60 mg tablet given once a day for 21 days.
15-60 mg oral tablet given once a day for 21 days.
他の名前:
  • OPC-41061

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change From Baseline in the Neurocognitive Composite Score of Speed Domains (NCS-SD; Sum of All Correct Speed Domain Z-Scores)
時間枠: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

二次結果の測定

結果測定
メジャーの説明
時間枠
Change From Baseline to Day 22 in the Individual Neurocognitive Domains Included in the Primary Endpoint: Reaction Time in Computer Tests
時間枠: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
時間枠: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
時間枠: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
時間枠: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)
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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)
時間枠: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
時間枠: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
時間枠: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)
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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)
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠:28 days
Incidence of potentially clinically significant ECG abnormalities: ST Segment
28 days
Number of Patients With Electrocardiogram (ECG) Abnormalities: T Wave
時間枠: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)
時間枠: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
時間枠:28 days
Incidence of potentially clinically significant ECG abnormalities: arrhythmia
28 days

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:Joseph Verbalis, MD、Georgetown University, Washington, DC, 20007 USA

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2007年8月1日

一次修了 (実際)

2009年2月1日

研究の完了 (実際)

2009年3月1日

試験登録日

最初に提出

2007年10月25日

QC基準を満たした最初の提出物

2007年10月26日

最初の投稿 (見積もり)

2007年10月29日

学習記録の更新

投稿された最後の更新 (見積もり)

2011年4月28日

QC基準を満たした最後の更新が送信されました

2011年4月26日

最終確認日

2011年4月1日

詳しくは

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

Placeboの臨床試験

3
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