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Safety and Efficacy of Aliskiren in Post Myocardial Infarction Patients (ASPIRE)

2012년 7월 5일 업데이트: Novartis

A 36-week, Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group Study Including a 2 Year Extension Study to Evaluate Efficacy and Safety of Aliskiren on the Prevention of Left Ventricular Remodeling in High Risk Post-acute Myocardial Infarction Patients When Added to Optimized Standard Therapy

The core and extension studies assessed the safety and efficacy of aliskiren when added to optimized standard therapy in patients that have had a high risk acute myocardial infarction (heart attack).

연구 개요

상태

완전한

연구 유형

중재적

등록 (실제)

820

단계

  • 3단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

      • Novartis Netherlands, 네덜란드
        • Novartis Netherlands
      • Novartis Norway, 노르웨이
        • Novartis Norway
      • Seoul, 대한민국, 100-803
        • Novartis Korea Ltd.
      • Novartis Denmark, 덴마크
        • Novartis Denmark
      • Novartis Germany, 독일
        • Novartis Germany
      • Novartis Russia, 러시아 연방
        • Novartis Russia
    • New Jersey
      • Novartis US, New Jersey, 미국
        • Novartis US
      • Caracas, 베네수엘라, 1062
        • Novartis de Venezuela, S.A.
      • Novartis Belgium, 벨기에
        • Novartis Belgium
      • Novartis Sweden, 스웨덴
        • Novartis Sweden
      • Novartis Spain, 스페인
        • Novartis Spain
      • Bratislava, 슬로바키아, SK-821 09
        • Novartis Slovakia
      • Novartis Argentina, 아르헨티나
        • Novartis Argentina
      • Novartis, 영국
        • Novartis UK
      • Petach Tikva, 이스라엘, IL-49250
        • Novartis Pharma
      • Novartis Italy, 이탈리아
        • Novartis Italy
      • Worli, Mumbai, 인도, 400018
        • Novartis Healthcare Private Limited
    • Praha 3
      • Praha, Praha 3, 체코 공화국, CZ-130 00
        • Novartis Czech Republic
      • Istanbul, 칠면조, TR-34353
        • Novartis Turkey
      • Novartis Canada, 캐나다
        • Novartis CANADA
      • Bogota, 콜롬비아
        • Novartis de Colombia S.A.
      • Warszawa, 폴란드, PL-00-710-
        • Novartis Poland Sp. z o.o.
      • Budapest, 헝가리, H-1537
        • Novartis Hungary

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Core Study Inclusion Criteria:

  • Male or female patients 18 years and older.
  • Patients within 7-42 days of an acute myocardial infarction associated with left ventricular systolic dysfunction.
  • Documented left ventricular systolic dysfunction associated with the qualifying acute myocardial.
  • Patients must be on stable doses of the following concomitant medications for at least 2 weeks prior to Visit 1 unless contraindicated due to intolerance:

    • A Beta-blocker
    • An Anti-platelet agent
    • A Statin
    • An evidence-based dose of an Angiotensin Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) but not both.
  • Qualifying Echocardiogram at Visit 1:

Core Study Exclusion Criteria:

  • Patients requiring both Angiotensin Converting Enzyme Inhibitor (ACEI) and Angiotensin Receptor Blocker (ARB) combination therapy at V1 or any time during the study.
  • Severe refractory hypertension defined as mean sitting systolic blood pressure (MSSBP) ≥ 180 mmHg and/or mean sitting diastolic blood pressure (MSDBP) ≥ 110 mmHg) at Visit 2.
  • Cardiogenic shock or systolic BP < 100 mmHg or diastolic < 60 mmHg within the 24 hours prior to Visits 1 or 2
  • Estimated Glomerular Filtration Rate (eGFR) < 30 ml/min/1.73m2 using the MDRD formula at Visit 1.
  • Stroke or transient ischemic event (TIA) within 6 months of Study Visit 1

Extension Study Inclusion Criteria:

  • Male or female patients who completed the core study through Visit 10 while on double-blind study drug
  • Patients who were able to participate in the study, and who consented to do so after the purpose and nature of the study had been clearly explained to them (written informed consent)

Extension Study Exclusion Criteria:

  • New York Heart Association (NYHA) class IV Congestive Heart Failure at Visit 1 (Core study Visit 10)
  • Symptomatic hypotension or reported systolic blood pressure (BP) < 90 mmHg within 24 hours prior to Visit 1 (Core study Visit 10)
  • Known Estimated Glomerular Filtration Rate (eGFR) < 30 mL/min/1.73m^2 using the Modification of Diet in Renal Disease (MDRD) formula at Visit 1 (Core study Visit 10)
  • Pregnant or nursing (lactating) women, where pregnancy was defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test (> 5 mIU/mL)
  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant Unless post-menopausal or using an acceptable method of contraception
  • Any surgical or medical condition that in the opinion of the investigator may place the patient at higher risk from his/her participation in the study or was likely to prevent the patient from complying with the requirements or completing the study

Other protocol-defined inclusion/exclusion criteria applied

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 더블

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Aliskiren

Core Study: Aliskiren ascending doses: 75 mg tablet for 1st week, 150 mg for 2nd week, 300 mg for next 34 weeks orally once daily in the morning.

Extension Study: Patients from both the core arms who completed core study and signed informed consent form were included in this arm of extension study.

Patients received 150 mg aliskiren tablet orally once a day for two weeks. Patients were then up-titrated to 300 mg aliskiren orally once a day at the discretion of the principal investigator based on their clinical condition for the duration of the study.

Aliskiren was available in 75 mg tablet, 150 mg tablet
다른 이름들:
  • Tekturna®
위약 비교기: placebo
Core study: placebo for 36 weeks once daily in the morning
Placebo tablets matching aliskiren for 36 weeks once daily in the morning for core period only.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Core Study: Change From Baseline in Left Ventricular End Systolic Volume (LVESV) as Measured by Echocardiography at End of Study.
기간: Baseline and final visit (after 26 to 36 weeks of treatment)
Change from baseline to end of study in left ventricular end systolic volume (LVESV) as measured by echocardiography. LVESV is a measurement of the volume of blood in the heart's left ventricular chamber at the end of the heart's contraction. This measurement was made by the echocardiography lab. LVESV values between 22 to 58 mL for men and 19-49 mL for women are considered normal. Baseline LVESV was a covariate.
Baseline and final visit (after 26 to 36 weeks of treatment)
Extension Study: Percentage of Participants With Deaths, Serious Adverse Events (SAEs), Discontinuation for Adverse Events (AEs) and Discontinuations for Abnormal Lab Values
기간: Extension study (24 weeks)
AEs are defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events are any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgment of investigators represent significant hazards.
Extension study (24 weeks)

2차 결과 측정

결과 측정
측정값 설명
기간
Core Study: Time to First Occurrence for the Composite Endpoints of Echocardiogram and Adjudicated Outcomes
기간: LVEF was measured at baseline and at final visit (after 26 to 36 weeks of treatment). Other endpoint components were assessed from randomization until the end of the study (week 36).
Composite outcome 1 included: Cardiovascular (CV) Death, hospitalization for heart failure (HF), or absolute reduction in Left Ventricular Ejection Fraction (LVEF) greater than 6%. Composite outcome 2 included: CV Death, hospitalization for HF, recurrent Myocardial Infarction, Stroke, or Resuscitated Sudden Death. LVEF was measured at baseline and final visit. All other events were adjudicated by a blinded external committee. Each composite endpoint analysis was based on (a) the percent of patients with that endpoint and (b) days in study to 1st event (or last exposure if no event occurred).
LVEF was measured at baseline and at final visit (after 26 to 36 weeks of treatment). Other endpoint components were assessed from randomization until the end of the study (week 36).
Core Study: Change From Baseline in Left Ventricular End Diastolic Volume (LVEDV)
기간: Baseline and final visit (after 26 to 36 weeks of treatment)
Change from baseline to end of study in left ventricular end diastolic volume (LVEDV) as measured by echocardiography. (LVEDV) is a measurement of the volume of blood in the heart's left ventricular chamber at the beginning of the chamber's filling with blood. This measurement was made by the echocardiography lab. LVEDV values between 67 to 155 mL for men and 56 to 104 mL for women are considered normal. Baseline LVEDV was a covariate.
Baseline and final visit (after 26 to 36 weeks of treatment)
Core Study: Change From Baseline in Left Ventricular Ejection Fraction (LVEF)
기간: Baseline and final visit (after 26 to 36 weeks of treatment )
Change from baseline to end of study in left ventricular ejection fraction (LVEF) (%) as measured by echocardiography. LVEF is the fraction of blood (in percent) pumped out of the heart's left ventricular chamber with each heart beat, and is a measure of cardiac output for the heart. This measurement was made by the echocardiography lab. Ejection fraction percentages > 55% are considered normal. Baseline LVEF was a covariate.
Baseline and final visit (after 26 to 36 weeks of treatment )
Core Study: Change From Baseline to End of Study in Infarction Segment Length (ISL) as Measured by Echocardiography
기간: Baseline and final visit (after 26 to 36 weeks of treatment)
Change from baseline to end of study in infarction segment length (ISL) (%) as measured by echocardiography. This is the length of the myocardial infarction segment as a percentage of the total cavity perimeter length as calculated by the echocardiography lab. Baseline ISL was a covariate.
Baseline and final visit (after 26 to 36 weeks of treatment)
Core Study: Change From Baseline to End of Study in Wall Motion Score (WMS) as Measured by Echocardiography
기간: Baseline and final visit (after 26 to 36 weeks of treatment)
Change from baseline to end of study in Wall Motion Score (WMS) as measured by echocardiography. WMS was obtained by examining multiple segments of the left ventricle and assigning each segment a score based on myocardial thickening: 1 for normal, 2 for hypokinetic; 3 for akinetic; and 4 for dyskinetic. The WMS was obtained as the average score for the segments visualized and was calculated by the echocardiography lab. Possible values range from 1 to 5. Higher scores are considered worse. Baseline WMS was a covariate.
Baseline and final visit (after 26 to 36 weeks of treatment)
Extension Study: Change From Baseline in Left Ventricular End Systolic Volume (LVESV) at Month 12
기간: Baseline(extension study), Month 12 (extension study)
Change from baseline to Month 12 in left ventricular end systolic volume (LVESV) as measured by echocardiography. LVESV is a measurement of the volume of blood in the heart's left ventricular chamber at the end of the heart's contraction. This measurement was made by the echocardiography lab. LVESV values between 22 to 58 mL for men and 19-49 mL for women are considered normal.
Baseline(extension study), Month 12 (extension study)
Extension Study: Change From Baseline in Left Ventricular End Diastolic Volume (LVEDV) at Month 12
기간: Baseline (extension study), Month 12 (extension study)
Change from baseline to Month 12 in left ventricular end diastolic volume (LVEDV) as measured by echocardiography. LVEDV is a measurement of the volume of blood in the heart's left ventricular chamber at the beginning of the chamber's filling with blood. This measurement was made by the echocardiography lab. LVEDV values between 67 to 155 mL for men and 56 to 104 mL for women are considered normal.
Baseline (extension study), Month 12 (extension study)
Extension Study: Change From Baseline in Left Ventricular Ejection Fraction (LVEF) at Month 12
기간: Baseline(extension study), Month 12 (extension study)
Change from baseline to Month 12 in left ventricular ejection fraction (LVEF) (%) as measured by echocardiography. LVEF is the fraction of blood (in percent) pumped out of the heart's left ventricular chamber with each heart beat, and is a measure of cardiac output for the heart. This measurement was made by the echocardiography lab. Ejection fraction percentages > 55% are considered normal.
Baseline(extension study), Month 12 (extension study)
Extension Study: Percentage of Participants With Orthostatic Blood Pressure Change
기간: Baseline (Day 0 Extension study), Week 2, Months 1, 3, 6, 9,16, 20, 24
Orthostatic blood pressure change is defined as a decrease of at least 20 mmHg in systolic blood pressure or a decrease of at least 10 mmHg in diastolic blood pressure when a patient moves from a sitting position to a standing position. A patient could show orthostatic blood pressure change at more than one visit. End of study is Month 24 or early discontinuation.
Baseline (Day 0 Extension study), Week 2, Months 1, 3, 6, 9,16, 20, 24
Extension Study: Percentage of Participants With Specified Criteria in Selected Labs by Laboratory Parameter
기간: 24 Months

Fasting blood samples were collected throughout the study and were analyzed at a central laboratory. Percentage of participants with the following clinically significant laboratory values are reported:

Potassium <3.5 mmol/L; Low value (Normal reference range: 3.5- 5.3)

Potassium >5.5 mmol/L and Potassium >6.0 mmol/L; High values (Normal reference range: 3.5-5.3)

Creatinine >176.8 μmol/L; High value (Normal reference range= Male: 62- 106 and Female 44- 80)

Blood Urea Nitrogen (BUN) >14.28; High value (Normal reference range: 2.1- 8.9)

24 Months

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

수사관

  • 연구 의자: Novartis US, Novartis

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작

2006년 12월 1일

기본 완료 (실제)

2009년 9월 1일

연구 완료 (실제)

2011년 7월 1일

연구 등록 날짜

최초 제출

2006년 12월 19일

QC 기준을 충족하는 최초 제출

2006년 12월 20일

처음 게시됨 (추정)

2006년 12월 21일

연구 기록 업데이트

마지막 업데이트 게시됨 (추정)

2012년 7월 13일

QC 기준을 충족하는 마지막 업데이트 제출

2012년 7월 5일

마지막으로 확인됨

2012년 7월 1일

추가 정보

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구독하다