Endocalyx in Treatment Resistent Hypertension

Phase 2

Recruiting

• Conditions: Treatment Resistant Hypertension

• Registration Number: NCT06940011
• Lead Sponsor: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Brief Summary

The goal of this randomized, double-blind, placebo-controlled study is to assess whether the food supplement Endocalyx lowers blood pressure in patients with treatment resistant hypertension.

Detailed Description

During this intervention study, subjects will receive either a placebo or Endocalyx for 12 weeks. The main objective of this study is to assess whether the food supplement Endocalyx lowers blood pressure in patients with treatment resistant hypertension.

Secondary objectives are:

* Change from baseline in office blood pressure and 24-hour blood pressure profiles in subjects with treatment resistant hypertension.

* To assess whether sodium intake, sex or kidney function modulates the effect of Endocalyx on blood pressure.

* Change from baseline in total vessel density, perfused vessel density, proportion of perfused vessels and microvascular health score

* To assess the effect of Endocalyx on total peripheral resistance.

* The effect of Endocalyx on quality of life.

* To estimate the potential impact of Endocalyx on long-term cardiovascular protection and health care costs.

Study Timeline

• Study First Submitted: 2025-01-20
• Study Start: 2025-01-21
• Status Verified: 2025-04
• Study First Submitted QC: 2025-04-15
• Last Update Submitted: 2025-04-15
• Study First Posted: 2025-04-23
• Last Update Posted: 2025-04-23
• Primary Completion: 2027-12-01
• Study Completion: 2028-01-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 64

Inclusion Criteria

1. Treatment resistant hypertension defined as

   1. an uncontrolled office BP (≥140/90 mmHg).
   2. is on a regimen of ≥3 adequately dosed antihypertensive agents of different classes, including a diuretic, at maximum tolerated dose based on investigator judgment.

2. Stable diuretic and antihypertensive treatment for the previous 3 weeks.

3. Subject, or legal representative, has voluntarily signed and dated an Informed Consent Form, approved by the Independent Ethics Committee (IEC).

Exclusion Criteria

1. Age <18 years.
2. Estimated glomerular filtration rate (eGFR) <20 ml/min/1.73m2 measured by the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine formula and the 2012 cystatin C CKD-EPI formula.
3. A mean seated systolic blood pressure of at least 180 mmHg or a diastolic blood pressure of at least 110 mmHg.
4. Known secondary hypertension
5. An acute coronary syndrome, stroke, transient ischemic attack or cardiovascular surgery in the last 3 months.
6. Hospitalization for heart failure in the past 3 weeks.
7. Dialysis treatment or expected initiation of dialysis within 3 months of screening.
8. Women of child bearing potential who are not taking adequate contraception (i.e. <1% failure rate).
9. Planned surgery in the next 12 weeks
10. Major surgery in the previous 4 weeks.
11. Use of prednisolone >5 mg/day
12. Use of any other investigational drug.
13. Presence of significant comorbidities (e.g., advanced malignancy, advanced liver disease) with a life expectancy of less than 1 year.
14. A psychiatric, addictive or any disorder that compromises ability to give truly informed consent for participation in this study.
15. Known hypersensitivity to seaweed, corn, artichoke, grape, melon or to any of the excipients of Endocalyx.
16. Known hypersensitivity or allergies for milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybeans.
17. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose galactose malabsorption.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Change from baseline in 24-hour systolic blood pressure	12 weeks	We will perform an uncorrected analysis and an analysis that is corrected for the reported and measured changes in antihypertensive medication use.

Secondary Outcome Measures

Name	Time	Method
Change from baseline in 24-hour diastolic blood pressure	12 weeks
Change from baseline in seated systolic office blood pressure	12 weeks
Change from baseline in seated diastolic office blood pressure	12 weeks
Percentage of patients that required lowering of their antihypertensive drugs during the study	12 weeks
Change from baseline in total vessel density and perfused vessel density	12 weeks	The total vessel density and perfused vessel density will be measured using Sidestream Dark Field imaging.
Change from baseline in proportion of perfused vessels	12 weeks	The proportion of perfussed vessels will be measured using Sidestream Dark Field imaging.
Change from baseline in microvascular flow index	12 weeks	The microvascular flow index will be measured using Sidestream Dark Field imaging.
Change from baseline in microvascular health score	12 weeks	The microvascular health score will be measured using Sidestream Dark Field imaging.
Change from baseline in heart rate	12 weeks	The heart rate will be measured using the Nexfin device
Change from baseline in total peripheral resistance	12 weeks	The total pheripheral resistance will be measured using the Nexfin device
Change from baseline in cardiac output	12 weeks	The cardiac output will be measured using the Nexfin device
Change from baseline in quality of life	12 weeks	Quality of life will be evaluated by the SF-36 questionnaire.
The potential impact of Endocalyx on long-term cardiovascular protection and health care costs.	12 weeks	The EQ-5D-5L questionnaire will be used to score a patient health status and will be transposed in quality adjusted life years (QALY's).
Change from baseline in skin sodium content	12 weeks	Skin sodium content will measured using a 7T sodium MRI
Change from baseline in muscle sodium content	12 weeks	Muscle sodium content will measured using a 7T sodium MRI
Change from baseline in skin water content	12 weeks	Skin water content will measured using a 7T H-MRI
Change from baseline in muscle water content	12 weeks	Muscle water content will measured using a 7T H-MRI
Change from baseline in transepidermal water loss	12 weeks	Transepidermal water loss will be measured with the Tewameter® TM Hex probe
Change from baseline in skin hydration	12 weeks	The skin hydration will be measured using the Corneometer® CM 825 probe
Change from baseline in total body water	12 weeks	The change in total body water (liter) will be measured using the bioelectrical impendance analysis
Incidence of adverse events in the Endocalyx group compared to the placebo group	12 weeks
Change from baseline in percentage of patients with a night-time blood pressure dip	12 weeks	The nighttime blood pressure dipping status will be measured with a 24-hour blood pressure measurements. Patients will be classified as a 'dippers' when the nighttime systolic blood pressure and/or diastolic blood pressure falls \>10% and \<20% compared to daytime readings. Exteme dippers are described as those with blood pressure fall of at least 20%. Patients with blood pressure fall between 0 and 10% are classified as non-dippers.
Percentage of patients achieving a seated office blood pressure <140/90 mmHg after intervention	12 weeks	Participants achieved a response if the systolic blood pressure is below 140 mmHg and the diastolic blood pressure is below 90 mmHg
Percentage of patients that needed additional antihypertensive drugs and/or higher dosage of antihypertensive drugs during the study	12 weeks

Trial Locations

Locations (1)

Amsterdam UMC; 🇳🇱 Amsterdam, Noord-Holland, Netherlands