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Anti-Inflammatory Actions of Valsartan in Patients With Type 2 Diabetes Mellitus

22 september 2009 bijgewerkt door: Charite University, Berlin, Germany

A 16-weeks, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Anti-inflammatory Actions of 320 mg Diovan in Patients With Type 2 Diabetes With and Without Coronary Artery Disease

This study is designed to support the use of valsartan in the diabetic population. Two different groups will be studied, one with and one without coronary artery disease (CAD) documented by angiography.

The study is intended to demonstrate that valsartan 320 mg has an anti-inflammatory potential, reducing inflammatory serum markers as well as inflammatory gene expression, and to show that valsartan is able to improve metabolic parameters in this patient population. Furthermore, in the subgroup of patients with documented CAD this study wants to show that valsartan improves coronary perfusion.

3 Objectives

Primary objectives:

  1. To demonstrate the anti-inflammatory efficacy of valsartan 160/320 mg by testing the hypothesis of superiority compared to placebo in the reduction of the inflammatory marker Tumor necrosis factor alpha (TNFα) in plasma after 16 weeks of treatment in hypertensive patients with type 2 diabetes mellitus.
  2. To demonstrate the anti-inflammatory efficacy of valsartan 160/320 mg by testing the hypothesis of superiority compared to placebo in the reduction of the inflammatory marker Interleukin 6 (IL-6) in plasma after 16 weeks of treatment in hypertensive patients with type 2 diabetes mellitus.

Secondary objectives:

  1. To explore the effect of 160/320 mg valsartan on parameters of insulin sensitivity.
  2. To explore the effect of 160/320 mg valsartan on additional inflammatory markers in plasma [e.g. C-Reactive protein (CRP), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), serum amyloid A (SAA), soluble CD40 ligand (sCD40L), fibrinogen, Interleukin 1β (IL-1β), matrix metalloproteases -2, -3 and -9 (MMP-2, -3, -9), and sE-selectin)].
  3. To explore the effect of 160/320 mg valsartan on inflammatory gene expression from monocytes and fat tissue.
  4. To explore the effect of 160/320 mg valsartan on metabolic gene expression in fat tissue.
  5. To explore the effect of 160/320 mg valsartan on coronary perfusion, in the group of patients with angiographically documented CAD.

Studie Overzicht

Studietype

Ingrijpend

Inschrijving

121

Fase

  • Fase 4

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

      • Berlin, Duitsland, 10115
        • Charité University Medicine Berlin, Center for Cardiovascular Research, Outpatient Clinic
    • Baden-Wuerttemberg
      • Ulm, Baden-Wuerttemberg, Duitsland, 89081
        • University of Ulm, Department of Internal Medicine II

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

30 jaar tot 80 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

NVT

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Male or female patients between 30 and 80 years old, inclusive
  • Controlled type 2 Diabetes Mellitus on stable treatment at least during the 4 weeks prior to visit 1
  • Treated or untreated stage 1 (according to JNC VII Guidelines) or grade 1 (according to ESH/ESC 2003 Guidelines) hypertensive patients
  • For one stratum: angiographically proven CAD
  • Signed informed consent prior to any study procedure

Exclusion Criteria:

  • Hypertension classified as stage 2 (or grade 2) or higher
  • Normotensive patients, i.e. patients who do not have a history of high blood pressure, and who are not receiving any antihypertensive medication
  • Treatment with more than 2 antihypertensive medications
  • Current treatment with ARBs
  • Glycated hemoglobin (HbA1c) >8.5% at Visit 1
  • Current treatment with glitazones
  • Myocardial infarction less than 3 months prior to Visit 1
  • Total cholesterol >7.8 mmol/l
  • Past diagnosis of any systemic inflammatory disease
  • Known or suspected contraindications, including history of allergy to angiotensin receptor blockers
  • History of hypertensive encephalopathy or cerebrovascular accident less than 1 year prior to Visit 1
  • Known Keith-Wagener grade III or IV hypertensive retinopathy
  • History of heart failure
  • Second or third degree heart block without a pacemaker
  • Concomitant unstable angina pectoris
  • Concurrent potential life threatening arrhythmia or symptomatic arrhythmia
  • Clinically significant valvular heart disease
  • Evidence of hepatic disease as determined by any one of the following: ALT or AST values > 2 x ULN at Visit 1, a history hepatic encephalopathy, a history of esophageal varices, or a history of portocaval shunt
  • Evidence of renal impairment as determined by any one of the following: serum creatinine >1.25 x ULN at visit 1, a history of dialysis, or a history of nephritic syndrome
  • Sodium value <132 mmol/L at Visit 1
  • Serum potassium values <3.5 mmol/L or >5.5 mmol/L at visit 1
  • Any surgical or medical condition which might alter the absorption, distribution, metabolism, excretion of any drug
  • Female patients who are not either post-menopausal for one year of surgically sterile, and who are not using effective contraceptive methods such as barrier method with spermicidal or an intra-uterine device. Oral contraceptive use or dermal implants as the only means of contraception are disallowed
  • Pregnant or lactating females
  • Any surgical or medical condition which, at the discretion of the investigator, place the patient at higher risk from his/her participation in the study, or are likely to prevent the patients from complying with the requirements of the study or completing the trial period
  • History of malignancy including leukemia and lymphoma within 5 years prior to Visit 1
  • History of any severe, life threatening disease within the past five years
  • Any previous history of a systemic autoimmune disease
  • History of drug or alcohol abuse within the last two years
  • Participation in any investigational drug trial within one month prior to visit 1

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Dubbele

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Placebo-vergelijker: Placebo
Actieve vergelijker: Valsartan

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
The primary objective of the study was to evaluate the anti-inflammatory effect of VAL by analyzing the reduction of the inflammatory markers interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα) in serum after 16 weeks of treatment.

Secundaire uitkomstmaten

Uitkomstmaat
To explore the effect of 160/320 mg valsartan on parameters of insulin sensitivity.
To explore the effect of 160/320 mg valsartan on additional inflammatory markers in plasma
To explore the effect of 160/320 mg valsartan on inflammatory gene expression from monocytes and fat tissue
To explore the effect of 160/320 mg valsartan on metabolic gene expression in fat tissue.
To explore the effect of 160/320 mg valsartan on coronary perfusion, in the group of patients with angiographically documented CAD

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 juli 2004

Primaire voltooiing (Werkelijk)

1 oktober 2006

Studie voltooiing (Werkelijk)

1 maart 2007

Studieregistratiedata

Eerst ingediend

22 september 2009

Eerst ingediend dat voldeed aan de QC-criteria

22 september 2009

Eerst geplaatst (Schatting)

23 september 2009

Updates van studierecords

Laatste update geplaatst (Schatting)

23 september 2009

Laatste update ingediend die voldeed aan QC-criteria

22 september 2009

Laatst geverifieerd

1 september 2009

Meer informatie

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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