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- Klinische proef NCT02439775
SPYRAL HTN-ON MED-onderzoek
Wereldwijde klinische studie van renale denervatie met het Symplicity Spyral™ multi-elektrode renale denervatiesysteem bij patiënten met ongecontroleerde hypertensie op standaard medische therapie (SPYRAL HTN-ON MED)
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Kogarah, Australië
- St. George Hospital
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Perth, Australië
- Royal Perth
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Victoria
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Melbourne, Victoria, Australië, 3004
- Alfred Hospital
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Ontario
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Hamilton, Ontario, Canada
- Hamilton Heath
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Toronto, Ontario, Canada
- St. Michael's Hospital
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Bad Krozingen, Duitsland, 79189
- Universitäts-Herzzentrum Freiburg - Bad Krozingen GmbH
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Erlangen, Duitsland, 91054
- Universitätsklinikum Erlangen
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Homburg, Duitsland, 66421
- Universitätsklinikum des Saarlandes
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Leipzig, Duitsland, 04289
- Herzzentrum Leipzig, Universitätsklinik
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Lübeck, Duitsland, 23560
- Sana Kliniken Lubeck
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Toulouse, Frankrijk
- Clinique Pasteur
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Athens, Griekenland, 11527
- Hippokration General Hospital of Athens
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Thessaloniki, Griekenland, 54621
- University General Hospital of Thessaloniki (AHEPA)
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Galway, Ierland
- Galway University Hospital
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Osaka, Japan
- Saiseikai Nakatsu Hospital
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Hyōgo
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Takarazuka, Hyōgo, Japan
- Higashi Takarazuka Satoh Hospital
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Okamoto
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Kamakura, Okamoto, Japan
- Shonan Kamakura General Hospital
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Tochigi
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Shimotsuke, Tochigi, Japan, 329-0498
- Jichi Medical University Hospital
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Tokyo
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Chiyoda City, Tokyo, Japan, 101-8643
- Mitsui Memorial Hospital
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Wels, Oostenrijk, 4600
- Klinikum Wels-Grieskirchen
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Bournemouth, Verenigd Koninkrijk
- Royal Bournemouth Hospital
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Cardiff, Verenigd Koninkrijk
- Cardiff and Vale University Health Board - University Hospital of Wales
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Exeter, Verenigd Koninkrijk, EX2 5DW
- Royal Devon & Exeter NHS Foundation Trust
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London, Verenigd Koninkrijk, W12 0HS
- Imperial College Healthcare NHS Trust
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Alabama
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Huntsville, Alabama, Verenigde Staten, 35801
- Heart Center Research, LLC
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California
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Stanford, California, Verenigde Staten, 94305
- Stanford Hospital and Clinics
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Connecticut
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New Haven, Connecticut, Verenigde Staten, 06520
- Yale New Haven Hospital
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District of Columbia
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Washington D.C., District of Columbia, Verenigde Staten, 20422
- Washington DC VA Medical Center
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Florida
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Jacksonville, Florida, Verenigde Staten, 32207
- Baptist Medical Center Jacksonville
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Jacksonville, Florida, Verenigde Staten, 32216
- Memorial Hospital Jacksonville
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Tallahassee, Florida, Verenigde Staten, 32308
- Tallahassee Research Institute
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Georgia
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Atlanta, Georgia, Verenigde Staten, 30308
- Emory University Hospital Midtown
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Atlanta, Georgia, Verenigde Staten, 30309
- Piedmont Heart Institute
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Iowa
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West Des Moines, Iowa, Verenigde Staten, 50266
- Iowa Heart Center
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Kentucky
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Lexington, Kentucky, Verenigde Staten, 40536
- University of Kentucky
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Michigan
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Pontiac, Michigan, Verenigde Staten, 48341
- St Joseph Mercy Oakland
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Southfield, Michigan, Verenigde Staten, 48075
- Providence Hospital
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Minnesota
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Minneapolis, Minnesota, Verenigde Staten, 55407
- Minneapolis Heart Institute Foundation
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Mississippi
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Hattiesburg, Mississippi, Verenigde Staten, 39401
- Hattiesburg Clinic
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Tupelo, Mississippi, Verenigde Staten, 38801
- Cardiology Associates Research LLC
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Missouri
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St Louis, Missouri, Verenigde Staten, 63110
- Barnes-Jewish Hospital
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New Jersey
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Livingston, New Jersey, Verenigde Staten, 07039
- Saint Barnabas Medical Center
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New York
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Manhasset, New York, Verenigde Staten, 11030
- North Shore University Hospital
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New York, New York, Verenigde Staten, 10029
- Mount Sinai Medical Center
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New York, New York, Verenigde Staten, 10021
- Weill Cornell Medical College/The New York Presbyterian Hospital
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North Carolina
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Durham, North Carolina, Verenigde Staten, 27710
- Duke University Medical Center
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Ohio
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Cleveland, Ohio, Verenigde Staten, 44106
- University Hospitals Cleveland Medical Center
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Oregon
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Portland, Oregon, Verenigde Staten, 97239
- Oregon Health & Science University Hospital
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Pennsylvania
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Harrisburg, Pennsylvania, Verenigde Staten, 17011
- PinnacleHealth Cardiovascular Institute
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Philadelphia, Pennsylvania, Verenigde Staten, 19104
- Hospital of the University of Pennsylvania
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Rhode Island
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Providence, Rhode Island, Verenigde Staten, 02906
- The Miriam Hospital
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South Carolina
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Anderson, South Carolina, Verenigde Staten, 29621
- AnMed Health
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Tennessee
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Nashville, Tennessee, Verenigde Staten, 37203
- Centennial Medical Center
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Texas
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Dallas, Texas, Verenigde Staten, 75226
- Baylor Heart & Vascular Hospital
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West Virginia
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Charleston, West Virginia, Verenigde Staten, 25304
- Charleston Area Medical Center
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Wisconsin
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Milwaukee, Wisconsin, Verenigde Staten, 53215
- Aurora St. Luke's Medical Center
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Beschrijving
Inclusiecriteria:
- Individu heeft kantoorsystolische bloeddruk (SBP) ≥ 150 mmHg en
- Individu heeft 24-uurs ambulante bloeddrukmeting (ABPM) gemiddelde SBP ≥ 140 mmHg en < 170 mmHg.
Uitsluitingscriteria:
- Individu mist de juiste anatomie van de nierslagader.
- Individu heeft een geschatte glomerulaire filtratiesnelheid (eGFR) van
- Individu heeft diabetes mellitus type 1 of slecht gecontroleerde diabetes mellitus type 2.
- Individu heeft een of meer episodes van orthostatische hypotensie.
- Individu heeft chronische zuurstofondersteuning of andere mechanische ventilatie nodig dan nachtelijke ademhalingsondersteuning voor slaapapneu.
- Individu heeft primaire pulmonale hypertensie.
- Individu is zwanger, geeft borstvoeding of is van plan zwanger te worden.
- Individu heeft frequente intermitterende of chronische pijn die resulteert in behandeling met niet-steroïde anti-inflammatoire geneesmiddelen (NSAID's) gedurende twee of meer dagen per week gedurende de maand voorafgaand aan inschrijving
- Individu heeft stabiele of onstabiele angina pectoris binnen 3 maanden na inschrijving, myocardinfarct binnen 3 maanden na inschrijving; hartfalen, cerebrovasculair accident of voorbijgaande ischemische aanval, of atriumfibrilleren op enig moment.
- Individueel werkt nachtdiensten.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Renale denervatie
Nierangiografie en nierdenervatie (Symplicity Spyral™ nierdenervatiesysteem met meerdere elektroden)
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Na een nierangiografie volgens standaardprocedures blijven proefpersonen geblindeerd en worden na randomisatie onmiddellijk behandeld met de procedure voor nierdenervatie.
Andere namen:
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Sham-vergelijker: Schijnprocedure
Renale angiografie
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Na een nierangiografie volgens standaardprocedures blijven proefpersonen geblindeerd en blijven ze ten minste 20 minuten op de laboratoriumtafel voor katheterisatie liggen voordat de inbrenghuls wordt verwijderd.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Verandering in de systolische bloeddruk zoals gemeten door 24-uurs ambulante bloeddrukmonitoring (ABPM)
Tijdsspanne: Vanaf baseline tot 6 maanden na de procedure
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Aan de uitgangssituatie aangepaste verandering (met behulp van analyse van covariantie) in de systolische bloeddruk (SBP) vanaf de uitgangswaarde (screeningsbezoek 2) tot 6 maanden na de procedure, zoals gemeten met 24-uurs ambulante bloeddrukmonitoring (ABPM).
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Vanaf baseline tot 6 maanden na de procedure
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Acute and Chronic Safety by Evaluating Incidence of Major Adverse Events
Tijdsspanne: From Baseline to 1 month post-procedure (6 months for new renal artery stenosis)
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The Primary safety endpoint of the study is the incidence of Major Adverse Events (MAE), defined as composite of the following events: All-cause mortality, End stage renal Disease (ESRD), Significant embolic event resulting in end-organ damage, Renal artery perforation requiring intervention, Renal artery dissection requiring intervention, Vascular complications, Hospitalization for hypertensive crisis not related to confirmed non-adherence with medications or the protocol, New renal artery stenosis >70%, confirmed by angiography and as determined by the angiographic core laboratory, through one-month post-randomization (6-months for new renal artery stenosis)
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From Baseline to 1 month post-procedure (6 months for new renal artery stenosis)
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Gebruik van antihypertensiva en veranderingen in 6 maanden
Tijdsspanne: Vanaf de basislijn tot 6 maanden na de procedure
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Aantal medicijnen vanaf baseline (screeningsbezoek 2) tot en met 6 maanden na de procedure
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Vanaf de basislijn tot 6 maanden na de procedure
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Antihypertensieve medicatielast tot 6 maanden
Tijdsspanne: Vanaf baseline tot 6 maanden na de procedure
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Op basis van de gerapporteerde voorgeschreven medicijnen werd de medicatielast berekend met behulp van de Medication Index 2-score, een samengestelde index gebaseerd op de doses antihypertensiva vermenigvuldigd met het aantal voorgeschreven medicijnen; alle klassen (ACE/ARB, calciumkanaalblokkers, enz.) werden qua potentie als gelijkwaardig beschouwd. Een hogere score geeft aan dat er hogere doseringen worden voorgeschreven dan de standaarddosis. Minimale waarde 0; Nee Maximale waarde |
Vanaf baseline tot 6 maanden na de procedure
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Medicatieveranderingen
Tijdsspanne: Basislijn tot 6 maanden na de procedure
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Patiënten bij wie medicatiewijzigingen zijn doorgevoerd op basis van medicijntestgegevens uit Medication Index 2.
Medicatie-index 2-score is een samengestelde index gebaseerd op de doses antihypertensiva vermenigvuldigd met het aantal voorgeschreven medicijnen; alle klassen (ACE/ARB, calciumkanaalblokkers, enz.) werden qua potentie als gelijkwaardig beschouwd.
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Basislijn tot 6 maanden na de procedure
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Incidentie van het bereiken van de beoogde systolische bloeddruk
Tijdsspanne: Vanaf baseline tot 6 maanden na de procedure
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Incidentie van het bereiken van de beoogde systolische bloeddruk (SBP<140 mmHg) 6 maanden na de procedure.
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Vanaf baseline tot 6 maanden na de procedure
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Change in Office Systolic Blood Pressure to 6-months
Tijdsspanne: From baseline to 6 months post-procedure
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Change in office systolic blood pressure from baseline (Screening Visit 2) to 6 months post-procedure
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From baseline to 6 months post-procedure
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Change in Systolic Blood Pressure as Measured by 24-hour ABPM 12 Months
Tijdsspanne: From Baseline to 12 months post procedure
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Change in systolic blood pressure from baseline (screening visit 2) to 12 months as measured by 24-hour Ambulatory Blood Pressure Monitoring (ABPM)
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From Baseline to 12 months post procedure
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Change in Systolic Blood Pressure as Measured by 24-hour ABPM 24-months
Tijdsspanne: From baseline to 24 months post-procedure
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Change in systolic blood pressure from baseline (screening visit 2) to 24 months as measured by 24-hour Ambulatory Blood Pressure Monitoring (ABPM).
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From baseline to 24 months post-procedure
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Change in Systolic Blood Pressure as Measured by 24-hour ABPM 36-months
Tijdsspanne: From baseline to 36 months post-procedure
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Change in systolic blood pressure from baseline (screening visit 2) to 36 months as measured by 24-hour Ambulatory Blood Pressure Monitoring (ABPM).
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From baseline to 36 months post-procedure
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Change in Office Systolic Blood Pressure to 12-months
Tijdsspanne: From Baseline to 12 months post procedure
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Change in office systolic blood pressure from baseline (screening visit 2) to 12 months.
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From Baseline to 12 months post procedure
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Change in Office Systolic Blood Pressure to 24-months
Tijdsspanne: From baseline to 24 months post-procedure
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Change in office systolic blood pressure from baseline (screening visit 2) to 24 months.
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From baseline to 24 months post-procedure
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Change in Office Systolic Blood Pressure to 36-months
Tijdsspanne: From baseline to 36 months post-procedure
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Change in office systolic blood pressure from baseline (screening visit 2) to 36 months.
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From baseline to 36 months post-procedure
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Change in Diastolic Blood Pressure as Measured by 24-hour ABPM 12-months
Tijdsspanne: From Baseline to 12 months post procedure
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Change in diastolic blood pressure from baseline (screening visit 2) to 12 months as measured by 24-hour Ambulatory Blood Pressure Monitoring (ABPM).
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From Baseline to 12 months post procedure
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Change in Diastolic Blood Pressure as Measured by 24-hour ABPM 24-months
Tijdsspanne: From baseline to 24 months post-procedure
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Change in diastolic blood pressure from baseline (screening visit 2) to 24 months as measured by 24-hour Ambulatory Blood Pressure Monitoring (ABPM).
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From baseline to 24 months post-procedure
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Change in Diastolic Blood Pressure as Measured by 24-hour ABPM 36-months
Tijdsspanne: From baseline to 36 months post-procedure
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Change in diastolic blood pressure from baseline (screening visit 2) to 36 months as measured by 24-hour Ambulatory Blood Pressure Monitoring (ABPM).
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From baseline to 36 months post-procedure
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Change in Office Diastolic Blood Pressure 12 Months
Tijdsspanne: From baseline to 12 months post-procedure
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Change in office diastolic blood pressure from baseline (screening visit 2) to 12 months.
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From baseline to 12 months post-procedure
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Change in Office Diastolic Blood Pressure 24 Months
Tijdsspanne: From baseline to 24 months post-procedure
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Change in office diastolic blood pressure from baseline (screening visit 2) to 24 months.
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From baseline to 24 months post-procedure
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Change in Office Diastolic Blood Pressure 36 Months
Tijdsspanne: From baseline to 36 months post-procedure
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Change in office diastolic blood pressure from baseline (screening visit 2) to 36 months.
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From baseline to 36 months post-procedure
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Number of Participants Achieving Target Office Systolic Blood Pressure 12 Months
Tijdsspanne: From baseline to 12 months post-procedure
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Incidence of Achieving Target Office Systolic Blood Pressure (SBP <140 mmHg)
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From baseline to 12 months post-procedure
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Number of Participants Achieving Target Office Systolic Blood Pressure 24 Months
Tijdsspanne: From baseline to 24 months post-procedure
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Incidence of Achieving Target Office Systolic Blood Pressure (SBP <140 mmHg).
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From baseline to 24 months post-procedure
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Number of Participants Achieving Target Office Systolic Blood Pressure. 36 Months
Tijdsspanne: From baseline to 36 months post-procedure
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Incidence of Achieving Target Office Systolic Blood Pressure (SBP <140 mmHg)
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From baseline to 36 months post-procedure
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Number of Participants With All Cause Mortality
Tijdsspanne: From Baseline to 36-months post procedure
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From Baseline to 36-months post procedure
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Number of Participants With End-Stage Renal Disease (ESRD)
Tijdsspanne: From Baseline to 36-months post-procedure
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End-stage Renal Disease (ESRD) - defined as two or more eGFR measurements <15 mL/min/1.73m2 at least 21 days apart and requiring dialysis for one of more of the following:
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From Baseline to 36-months post-procedure
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Number of Participants With Significant Embolic Event Resulting in End-organ Damage
Tijdsspanne: From Baseline to 36 months post-procedure
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From Baseline to 36 months post-procedure
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Number of Participants With Renal Artery Perforation Requiring Intervention
Tijdsspanne: From Baseline to 36 month post-procedure
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Renal artery perforation requiring intervention
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From Baseline to 36 month post-procedure
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Number of Participants With Renal Artery Dissection Requiring Intervention
Tijdsspanne: From Baseline to 36 months post-procedure
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Number of Participants with Renal artery dissection requiring intervention
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From Baseline to 36 months post-procedure
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Number of Participants With Vascular Complications
Tijdsspanne: From Baseline to 36 months post-procedure
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Vascular complications (e.g., clinically significant groin hematoma, arteriovenous fistula, pseudoaneurysm, excessive bleeding) requiring surgical repair, interventional procedure, thrombin injection, or blood transfusion (requiring more than 2 units of packed red blood cells within any 24 hour period during the first 7 days post renal denervation procedure).
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From Baseline to 36 months post-procedure
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Number of Participants With Hospitalization for Hypertensive Crisis Not Related to Confirmed Non-adherence With Medications and/or the Protocol.
Tijdsspanne: From Baseline to 36 months post-procedure
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From Baseline to 36 months post-procedure
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Number of Participants With New Renal Artery Stenosis > 70%, Confirmed by Angiography and as Determined by the Angiographic Core Laboratory
Tijdsspanne: From Baseline to 36 months post-procedure
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From Baseline to 36 months post-procedure
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Number of Participants With ≥ 40% Decline in eGFR
Tijdsspanne: From baseline to 36 months post-procedure
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From baseline to 36 months post-procedure
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Number of Participants With Increase in Serum Creatinine >50% From Screening Visit 2 (Baseline)
Tijdsspanne: From baseline to 36 months post-procedure
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From baseline to 36 months post-procedure
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Number of Participants With New Myocardial Infarct
Tijdsspanne: From baseline to 36 months post-procedure
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From baseline to 36 months post-procedure
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Number of Participants With New Stroke
Tijdsspanne: From baseline to 36 months post-procedure
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From baseline to 36 months post-procedure
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Number of Participants With Renal Artery Re-intervention
Tijdsspanne: From baseline to 36 months post-procedure
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From baseline to 36 months post-procedure
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Number of Participants With Major Bleeding According to TIMI Definition
Tijdsspanne: From baseline to 36 months post-procedure
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Major bleeding according to TIMI definition (i.e.
intracranial hemorrhage, ≥5g/dl decrease in hemoglobin concentration, a ≥15% absolute decrease in hematocrit, or death due to bleeding within 7 days of the procedure
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From baseline to 36 months post-procedure
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Change in Diastolic Blood Pressure as Measured by 24-hour (ABPM) 6-months
Tijdsspanne: From baseline to 6 months post-procedure
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Change in diastolic blood pressure from baseline (screening visit 2) to 6 months as measured by 24-hour Ambulatory Blood Pressure Monitoring (ABPM).
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From baseline to 6 months post-procedure
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Change in Office Diastolic Blood Pressure to 6-months
Tijdsspanne: From baseline to 6 months post-procedure
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Change in office diastolic blood pressure from baseline (screening visit 2) to 6 months post-procedure
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From baseline to 6 months post-procedure
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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Antihypertensive Medication Burden to 36-months
Tijdsspanne: From baseline to 36 months post-procedure
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Based on the prescribed medications reported, medication burden was calculated using Medication Index 2 score which is a composite index based on the doses of antihypertensive medications multiplied by the number of medications prescribed; all classes (ACE/ARB, calcium channel blockers, etc.) were considered equivalent in potency. Higher score indicates higher dosages being prescribed over the standard dose. There are no clinically established thresholds. Minimum Value 0; No Maximum value (See Secondary Outcome Measure #5 for comparison) |
From baseline to 36 months post-procedure
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Antihypertensive Medication Burden to 24-months
Tijdsspanne: From baseline to 24 months post-procedure
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Based on the prescribed medications reported, medication burden was calculated using Medication Index 2 score which is a composite index based on the doses of antihypertensive medications multiplied by the number of medications prescribed; all classes (ACE/ARB, calcium channel blockers, etc.) were considered equivalent in potency. Higher score indicates higher dosages being prescribed over the standard dose. There are no clinically established thresholds. Minimum Value 0; No Maximum value (See Secondary Outcome Measure #5 for comparison) |
From baseline to 24 months post-procedure
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Antihypertensive Medication Burden to 12-Months
Tijdsspanne: From Baseline to 12 months post-procedure
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Based on the prescribed medications reported, medication burden was calculated using Medication Index 2 score which is a composite index based on the doses of antihypertensive medications multiplied by the number of medications prescribed; all classes (ACE/ARB, calcium channel blockers, etc.) were considered equivalent in potency. Higher score indicates higher dosages being prescribed over the standard dose. There are no clinically established thresholds. Minimum Value 0; No Maximum value (See Secondary Outcome Measure #5 for comparison) |
From Baseline to 12 months post-procedure
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Raymond Townsend, MD, University of Pennsylvania
- Hoofdonderzoeker: David Kandzari, MD, Piedmont Hospital
- Hoofdonderzoeker: Michael Böhm, MD, Universitätskliniken des Saarlandes
- Hoofdonderzoeker: Kazuomi Kario, MD, Jichi Medical University
Publicaties en nuttige links
Algemene publicaties
- Mahfoud F, Kandzari DE, Kario K, Townsend RR, Weber MA, Schmieder RE, Tsioufis K, Pocock S, Dimitriadis K, Choi JW, East C, D'Souza R, Sharp ASP, Ewen S, Walton A, Hopper I, Brar S, McKenna P, Fahy M, Bohm M. Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial. Lancet. 2022 Apr 9;399(10333):1401-1410. doi: 10.1016/S0140-6736(22)00455-X. Epub 2022 Apr 4.
- Kandzari DE, Hickey GL, Pocock SJ, Weber MA, Bohm M, Cohen SA, Fahy M, Lamberti G, Mahfoud F. Prioritised endpoints for device-based hypertension trials: the win ratio methodology. EuroIntervention. 2021 Apr 2;16(18):e1496-e1502. doi: 10.4244/EIJ-D-20-01090.
- Kario K, Weber MA, Bohm M, Townsend RR, Mahfoud F, Schmieder RE, Tsioufis K, Cohen SA, Fahy M, Kandzari DE. Effect of renal denervation in attenuating the stress of morning surge in blood pressure: post-hoc analysis from the SPYRAL HTN-ON MED trial. Clin Res Cardiol. 2021 May;110(5):725-731. doi: 10.1007/s00392-020-01718-6. Epub 2020 Aug 1.
- Kandzari DE, Bohm M, Mahfoud F, Townsend RR, Weber MA, Pocock S, Tsioufis K, Tousoulis D, Choi JW, East C, Brar S, Cohen SA, Fahy M, Pilcher G, Kario K; SPYRAL HTN-ON MED Trial Investigators. Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial. Lancet. 2018 Jun 9;391(10137):2346-2355. doi: 10.1016/S0140-6736(18)30951-6. Epub 2018 May 23.
- Kandzari DE, Kario K, Mahfoud F, Cohen SA, Pilcher G, Pocock S, Townsend R, Weber MA, Bohm M. The SPYRAL HTN Global Clinical Trial Program: Rationale and design for studies of renal denervation in the absence (SPYRAL HTN OFF-MED) and presence (SPYRAL HTN ON-MED) of antihypertensive medications. Am Heart J. 2016 Jan;171(1):82-91. doi: 10.1016/j.ahj.2015.08.021. Epub 2015 Sep 11.
- Bohm M, Townsend RR, Kario K, Kandzari D, Mahfoud F, Weber MA, Schmieder RE, Tsioufis K, Hickey GL, Fahy M, DeBruin V, Brar S, Pocock S. Rationale and design of two randomized sham-controlled trials of catheter-based renal denervation in subjects with uncontrolled hypertension in the absence (SPYRAL HTN-OFF MED Pivotal) and presence (SPYRAL HTN-ON MED Expansion) of antihypertensive medications: a novel approach using Bayesian design. Clin Res Cardiol. 2020 Mar;109(3):289-302. doi: 10.1007/s00392-020-01595-z. Epub 2020 Feb 7.
- Kandzari DE, Mahfoud F, Townsend RR, Kario K, Weber MA, Schmieder RE, Tsioufis K, Pocock S, Liu M, DeBruin V, Brar S, Bohm M. Long-Term Safety and Efficacy of Renal Denervation: 24-Month Results From the SPYRAL HTN-ON MED Trial. Circ Cardiovasc Interv. 2025 Jul;18(7):e015194. doi: 10.1161/CIRCINTERVENTIONS.125.015194. Epub 2025 May 20.
- Townsend RR, Ferdinand KC, Kandzari DE, Kario K, Mahfoud F, Weber MA, Schmieder RE, Pocock S, Tsioufis K, David S, Steigerwalt S, Walton A, Hopper I, Bertolet B, Sharif F, Fengler K, Fahy M, Hettrick DA, Brar S, Bohm M. Impact of Antihypertensive Medication Changes After Renal Denervation Among Different Patient Groups: SPYRAL HTN-ON MED. Hypertension. 2024 May;81(5):1095-1105. doi: 10.1161/HYPERTENSIONAHA.123.22251. Epub 2024 Feb 5.
- Kandzari DE, Townsend RR, Kario K, Mahfoud F, Weber MA, Schmieder RE, Pocock S, Tsioufis K, Konstantinidis D, Choi J, East C, Lauder L, Cohen DL, Kobayashi T, Schmid A, Lee DP, Ma A, Weil J, Agdirlioglu T, Schlaich MP, Shetty S, Devireddy CM, Lea J, Aoki J, Sharp ASP, Anderson R, Fahy M, DeBruin V, Brar S, Bohm M; SPYRAL HTN-ON MED Investigators. Safety and Efficacy of Renal Denervation in Patients Taking Antihypertensive Medications. J Am Coll Cardiol. 2023 Nov 7;82(19):1809-1823. doi: 10.1016/j.jacc.2023.08.045.
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