A Double-Blind, Randomized, Placebo-Controlled, 5-Arm Titration Study to Evaluate the Efficacy and Safety of TAK-491 When Compared With Valsartan and Olmesartan in Subjects With Essential Hypertension
Overview
- Phase
- Phase 3
- Intervention
- Azilsartan medoxomil
- Conditions
- Hypertension
- Sponsor
- Takeda
- Enrollment
- 1291
- Primary Endpoint
- Change From Baseline in the 24-hour Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.
- Status
- Completed
- Last Updated
- 15 years ago
Overview
Brief Summary
The purpose of this study is to evaluate the efficacy and safety of azilsartan medoxomil, once daily (QD), compared to placebo, valsartan and olmesartan in participants with essential hypertension.
Detailed Description
Hypertension affects approximately 50 million individuals in the United States. As the population ages, the prevalence of hypertension will continue to increase if broad and effective preventive measures are not implemented. According to the World Health Organization, hypertension is the most common attributable cause of preventable death in developed nations, as uncontrolled hypertension greatly increases the risk of cardiovascular disease, cerebrovascular disease, and renal failure. Despite the availability of antihypertensive treatments, hypertension remains inadequately controlled: only about one-third of patients successfully maintain control. A major component of blood pressure regulation is the renin-angiotensin-aldosterone system. This is a system of hormone-mediated feedback interactions that result in the relaxation or constriction of blood vessels in response to various stimuli. Angiotensin II, a polypeptide hormone, is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme as part of the renin-angiotensin-aldosterone system. Angiotensin II is the principal pressor agent of the renin-angiotensin-aldosterone system and has multiple effects on the cardiovascular system and on electrolyte homeostasis. TAK-491 (azilsartan medoxomil) is an angiotensin II type 1 receptor antagonist currently being tested as a treatment for essential hypertension. Study participation is anticipated to be about 10 weeks. Multiple procedures will occur at each visit which may include fasting, blood collection, urine collection, physical examinations, electrocardiograms and ambulatory blood pressure monitoring. Outside of the study center, participants will be required wear an ambulatory blood pressure monitoring device at 24 hour intervals.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Essential hypertension (sitting systolic blood pressure between 150 and 180 mm Hg, inclusive, at Day -1 and 24-hour mean systolic blood pressure between 130 and 170 mm Hg, inclusive, at Day 1).
- •Capable of understanding and complying with protocol requirements.
- •Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study
- •Clinical laboratory evaluations within the reference range for the testing laboratory or the results are deemed not clinically significant for inclusion into this study by the investigator.
- •Willing to discontinue current antihypertensive medications at Screening Day 21 visit. If the participant is on amlodipine prior to Screening, the participant is willing to discontinue this medication at Screening Day -28.
Exclusion Criteria
- •Sitting diastolic blood pressure greater than 114 mm Hg at Day -1 (day prior to Randomization).
- •Baseline 24-hour ambulatory blood pressure monitor reading of insufficient quality.
- •Taking or expected to take an excluded medication as described in the Excluded Medications.
- •Hypersensitive to angiotensin II receptor blockers.
- •History of myocardial infarction, heart failure, unstable angina, coronary artery bypass graft, percutaneous coronary intervention, hypertensive encephalopathy, cerebrovascular accident, or transient ischemic attack.
- •Clinically significant cardiac conduction defects.
- •Hemodynamically significant left ventricular outflow obstruction due to aortic valvular disease.
- •Secondary hypertension of any etiology.
- •Noncompliant (less than 70% or greater than 130%) with study medication during run-in period.
- •Moderate to severe renal dysfunction or disease.
Arms & Interventions
Azilsartan Medoxomil 40 mg QD
Intervention: Azilsartan medoxomil
Azilsartan Medoxomil 80 mg QD
Intervention: Azilsartan medoxomil
Valsartan 320 mg QD
Intervention: Valsartan
Olmesartan 40 mg QD
Intervention: Olmesartan
Placebo QD
Intervention: Placebo
Outcomes
Primary Outcomes
Change From Baseline in the 24-hour Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.
Time Frame: Baseline and Week 6.
The change in 24-hour mean systolic blood pressure measured at week 6 relative to baseline. Ambulatory blood pressure monitoring measures blood pressure at regular intervals throughout the day and night. The 24-hour mean is the average of all measurements recorded for 24 hours after dosing.
Secondary Outcomes
- Change From Baseline in Mean Trough Clinic Sitting Systolic Blood Pressure.(Baseline and Week 6.)
- Change From Baseline in the 24-hour Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.(Baseline and Week 6.)
- Change From Baseline in Mean Trough Clinic Sitting Diastolic Blood Pressure(Baseline and Week 6.)
- Change From Baseline in Daytime (6am to 10 pm) Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.(Baseline and Week 6.)
- Change From Baseline in Daytime (6am to 10 pm) Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.(Baseline and Week 6.)
- Change From Baseline in the Nighttime (12 am to 6 am) Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.(Baseline and Week 6.)
- Change From Baseline in the Nighttime (12 am to 6 am) Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.(Baseline and Week 6.)
- Change From Baseline in the 12-hour Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.(Baseline and Week 6.)
- Change From Baseline in the 12-hour Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.(Baseline and Week 6.)
- Change From Baseline in the Trough (22-24-hr) Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.(Baseline and Week 6.)
- Change From Baseline in the Trough (22-24-hr) Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.(Baseline and Week 6.)
- Percentage of Participants Who Achieve a Clinic Systolic Blood Pressure Response, Defined as < 140 mm Hg and/or Reduction From Baseline ≥ 20 mm Hg(Baseline and Week 6.)
- Percentage of Participants Who Achieve a Clinic Diastolic Blood Pressure Response, Defined as < 90 mm Hg and/or Reduction From Baseline ≥ 10 mm Hg(Baseline and Week 6.)
- Percentage of Participants Who Achieve Both a Clinic Diastolic and Systolic Blood Pressure Response(Baseline and Week 6.)