Safety and Tolerability and Efficacy of LCZ696 in Japanese Severe Hypertensive Patients

Phase 3

Completed

Brief Summary: This study assessed the safety, tolerability, and efficacy of LCZ696 in severe hypertensive Japanese patients

Detailed Description: Summaries for treatment-emergent adverse events, serious adverse events and death were provided by the following actual treatment regimen (actual treatment patients received) in addition to all patients: LCZ696 200mg, 400mg, 400mg+other hypertensive medications.

Summaries for others than above were provided by the following treatment regimen (determined by the maximal treatment patients received) in addition to all patients: LCZ696 200mg, 400mg, 400mg+other hypertensive medications.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Patients show msSBP ≥220 mmHg and/or msDBP ≥120 mmHg
History of angioedema, drug-related or otherwise, as reported by the patient
Patients unwilling or not able to discontinue safely the use of current antihypertensive medications during the study, as required by the protocol.
Patients have significant cardiovascular co-morbidities
Patients who previously entered a LCZ696 study and had been randomized or enrolled into the active drug treatment epoch.

Other protocol defined inclusion/exclusion criteria may apply.

Arm && Interventions

Group	Intervention	Description
LCZ696 200 mg	LCZ696	All participants were started on LCZ696 200 mg once daily on day 1. Participants who achieved mean sitting diastolic blood pressure (msDBP) of \< 100 mmHg and mean sitting systolic blood pressure (msSBP) of \< 160 mmHg at week 2 or a msDBP \< 90 mmHg and msSBP \< 140 mmHg at or after week 4 and for the duration of the study continued at 200 mg LCZ696 once daily.
LCZ696 400 mg	LCZ696	All participants were started on LCZ696 200 mg once daily on day 1. For participants who did not achieve mean sitting diastolic blood pressure (msDBP) of \< 100 mmHg and mean sitting systolic blood pressure (msSBP) of \< 160 mmHg at week 2 or a msDBP \< 90 mmHg and msSBP \< 140 mmHg at or after week 4, and did not have any signs of safety concerns, the LCZ696 dose was increased to 400 mg once daily.
LCZ696 400 mg plus other hypertension (HTN) medications	LCZ696	All participants were started on LCZ696 200 mg once daily on day 1. For participants who received LCZ696 400 mg and did not achieve msDBP \< 90 mmHg and msSBP \< 140 mmHg at or after week 4 and had no signs of safety concerns, another class of antihypertensive drugs (other than Angiotensin II receptor blockers or Angiotensin Converting Enzyme Inhibitor (ACEi) could be added, or the dose of concomitant antihypertensive drugs could be increased as per the package insert. Participants who received LCZ696 400 mg once daily did not change their dose for the remainder of the study.

Primary Outcome Measures

Name	Time	Method
Percentage of Participants With Adverse Events (AEs), Serious Adverse Events and Deaths	Week 8	Adverse events, serious adverse events deaths were monitored from screening to week 8.

Secondary Outcome Measures

Name	Time	Method
Change From Baseline in msSBP and msDBP at Week 8	Baseline, 8 weeks	Sitting BP measurements were performed at screening through the end of study at every visit. Four separate sitting BP measurements were obtained with a full two-minute interval between measurements. The 4 measurements were summed and averaged, and then the baseline BP value was subtracted from the average value to get the change from baseline value.
Percentage of Participants With SBP Response at End of Study	Baseline, 8 weeks	SBP response was defined as \<140 mmHg or a reduction ≥ 20 mmHg from baseline.
Percentage of Participants With Successful Blood Pressure (BP) Control in msSBP/msDBP at End of Study	8 weeks	Successful BP control in patients with severe hypertension at the end of study treatment was defined as follows: msSBP/msDBP\< 140/90 mmHg.
Percentage of Participants Achieving Successful msSBP Control at End of Study	8 weeks	Successful msSBP control in patients with severe hypertension at the end of study treatment was defined as msSBP \<140 mmHg.
Percentage of Participants Achieving Successful msDBP Control at End of Study	8 weeks	Successful msDBP control in patients with severe hypertension at the end of study treatment was defined as msDBP \< 90 mmHg.
Percentage of Participants With DBP Response at End of Study	Baseline, 8 weeks	DBP response was defined as \<90 mmHg or a reduction ≥ 10 mmHg from baseline.