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Tilt-Table Study of the Clinical Efficacy of Midodrine in Symptomatic Orthostatic Hypotension

Phase 4
Completed
Conditions
Orthostatic Hypotension
Interventions
Drug: Placebo
Registration Number
NCT01518946
Lead Sponsor
Shire
Brief Summary

The purpose of this study is to determine whether midodrine works against the symptoms of orthostatic hypotension caused by being on a tilt table.

Detailed Description

The efficacy of midodrine will be assessed in those subjects who have severe symptoms of orthostatic hypotension when not taking midodrine and are controlled when taking midodrine. The study will involve approximately 4 overnight stays.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
24
Inclusion Criteria
  1. Male and female subjects must be 18 years of age or older and ambulatory.
  2. Females of child-bearing potential (FOCP) must have a negative serum beta human chorionic gonadotropin (HCG) pregnancy test.
  3. A documented history of severe Symptomatic Orthostatic Hypotension (SOH) that, in the judgment of the treating physician, has required treatment with midodrine HCl , and has been at a stable dose for at least 3 months.
  4. The subject has manifested at least 1 of the following symptoms while standing or had a medical history of 1 of the following when not treated for orthostatic hypotension (OH): dizziness, lightheadedness, feeling faint, or feeling like they might black out.
Exclusion Criteria
  1. The subject is a pregnant or lactating female.
  2. The subject has pre-existing sustained supine hypertension greater than 180mmHg systolic and 110mmHg diastolic BP or had these measurements at the Screening Visit. Sustained is defined as persistently greater at 2 separate measurements at least 5 minutes apart with the subject supine and at rest for the 5 minutes.
  3. Subjects taking concomitant medications of interest are excluded unless those medications are reviewed and discussed with the Medical Monitor or Study Physician and documented prior to enrolling the subject. If agreement is reached between the Investigator and Sponsor for the subject to continue in the study, all allowed medications should be maintained at a constant dose throughout the study.
  4. The Principal Investigator deems any clinical laboratory test (at the Screening Visit) abnormality to be clinically significant
  5. The subject has participated in other studies of investigational drugs or devices within 30 days prior to enrollment in this study (other than Study SPD426-406).
  6. Current or relevant history of physical or psychiatric illness, any medical disorder that may require treatment or make the subject unlikely to fully comply with the requirements of the study or complete the study, or any condition that presents undue risk from the investigational product or study procedures.
  7. The subject has a concurrent chronic or acute illness, disability, or other condition (including significant unexpected laboratory or electrocardiogram [ECG] findings) that might confound the results of the tests and/or measurements administered in this study, or that might have increased the risk to the subject.
  8. Known or suspected intolerance or hypersensitivity to the investigational product(s), closely-related compounds, or any of the stated ingredients.
  9. Prior enrollment failure or randomization in this study.
  10. History of alcohol abuse or other substance abuse within the last year.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
PlaceboPlacebo-
Midodrine HClMidodrine HCl-
Primary Outcome Measures
NameTimeMethod
Time to Onset of Syncope/Near Syncope While on Tilt Table1 hour post-dose

After a 30-minute supine period, the table was tilted from 0-90ยบ within 30 seconds and maintained in that position for 45 minutes or until endpoint. Subjects were monitored for near-syncopal symptoms (subject felt sufficiently dizzy, lightheaded, faint, or felt like they were about to black out and requested the table to be returned to horizontal). Such a report ended the test. Alternatively, if the investigator observed that the subject was about to lose consciousness, that also constituted an endpoint.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (13)

Parkinson's Disease and Movement Disorders Center of Boca Raton

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Boca Raton, Florida, United States

Advance Research Institute Inc

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New Port Richey, Florida, United States

Kidney and Hypertension Center

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Roseburg, Oregon, United States

NYU Medical Centre

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New York, New York, United States

Columbia University

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New York, New York, United States

Cleveland Clinic

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Cleveland, Ohio, United States

Aurora Cardiovascular Services

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Milwaukee, Wisconsin, United States

Analab Clinical Research Inc

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Lenexa, Kansas, United States

Buffalo Clinical Research Center (BCRC)

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Buffalo, New York, United States

New Orleans Center for Clinical Research - Knoxville

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Knoxville, Tennessee, United States

Aspen Clinical Research

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Orem, Utah, United States

The Heartbeat Clinic, PA

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McKinney, Texas, United States

Mayo Clinic

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Rochester, Minnesota, United States

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