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Pharmacodynamic Equivalence of Ramipril 10 mg and Atorvastatin 40 mg Administered as a Cardiovascular (CV) Polypill Acetylsalicylic Acid-Atorvastatin-Ramipril (AAR) as Compared to Monotherapy

Phase 2
Conditions
Hypertension
Interventions
Drug: Cardiovascular Fixed Dose Combination Pill AAR
Registration Number
NCT02791958
Lead Sponsor
Ferrer Internacional S.A.
Brief Summary

This study is to compare the pharmacodynamics of a Fixed Dose Combination Pill AAR (acetylsalicylic acid 100 mg, atorvastatin 40 mg and ramipril 10 mg) and the respective reference products, atorvastatin (Lipitor®) 40 mg and ramipril (Altace®) 10 mg.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
528
Inclusion Criteria
  • Male or female patients aged ≥18 and <75 years.
  • Patients with Stage 1 (SBP/DBP: 140-159/90-99 mmHg) or Stage 2 (SBP/DBP: ≥160/≥100 mmHg) hypertension, either untreated or after a wash out period.
  • Patients with an LDL cholesterol level of ≥100 mg/dL and, either untreated or after the wash out period.
  • Patients untreated with BP lowering and / or lipid lowering medication
  • Patients treated with BP lowering and / or lipid lowering medication can be included if the medication can be safely withdrawn as per physician's judgment.
  • Provide written informed consent.
Exclusion Criteria
  • Patients with a BMI of > 35

  • SBP < 140 mmHg and DBP < 90 mmHg

  • Severe hypertension defined as SBP > 180 mmHg and Diastolic Blood Pressure (DBP) > 110 mmHg

  • LDL cholesterol level of <100 mg/dL, either untreated or after the wash out period.

  • Serum triglyceride concentration ≥400 mg/dL, either untreated or after the wash out period.

  • Patients with a medical condition requiring the chronic pharmacological treatments listed below:

    • Cytochrome P450 3A4 (CYP3A4) inhibitors (eg itraconazole, ketoconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, and nefazodone).
    • Non-steroidal anti-inflammatory drugs (NSAIDs).
    • K-sparing diuretics.
    • Lithium.
    • Amiodarone and verapamil.
    • Oral anticoagulants (eg, warfarin).
    • Steroids.
    • Digoxin.
    • Gemfibrozil.
    • Niacin.
    • Potassium supplements.
    • Cyclosporine.
    • Danazol.
    • Rifampicin.
  • Evidence of any known clinically significant chronic disease

  • Patients with renal impairment with Creatinine Clearance (CrCl) < 40 mL/ min/ 1.73 m2

  • Creatine phosphokinase (CPK) ≥5 x the upper limit of normal (ULN).

  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 3 x ULN.

  • Total bilirubin ≥1.5 x ULN

  • Medical history or evidence of drug or alcohol abuse.

  • Medical history of gastrointestinal bleeding or gastroduodenal ulcer.

  • Presence of secondary dyslipidemia.

  • For patients on antihypertensive and/ or cholesterol lowering medication impossibility to withdraw it safely as per physician's judgment

  • Previous coronary artery bypass graft (CABG).

  • Previous percutaneous transluminal coronary angioplasty (PTCA) with a drug-eluting stent.

  • Presence of severe congestive heart failure (New York Heart Classification (NYHC) III IV).

  • Prior history of stroke, Transient Ischemic Attack (TIA), Myocardial Infarction (MI), and cardiomyopathy with systolic dysfunction (prior documented Left Ventricular Ejection Fraction (LVEF) < 40%)

  • Aspirin induced asthma

  • Previous intolerance and/or hypersensitivity to ACE inhibitors, statins and/or salicylates.

  • Presence of unstable angina.

  • Lab values other than specified out of the central laboratory normal range considered clinically significant.

  • Patients and their partners not using effective contraception methods (i.e. intra uterine device (IUD) and condom or diaphragm with spermicide and condom) during the study and for at least one month thereafter, oral contraceptives are allowed.

  • Pregnant, lactating, breastfeeding, or intends to become pregnant during the course of the study (females only). All women must have a negative urine pregnancy test at the Screening Visit, be surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy) or have a postmenopausal status (no menses) for at least one year.

  • Presence of mental illness limiting the capacity for self-care.

  • Presence of major systemic illnesses: renal disease, liver disease, neurological or psychiatric disease.

  • Participation, in the 30 days preceding enrolment into the study, in any other clinical study in which investigational or marketed drugs were employed.

  • Any other medical condition that in the investigators opinion may interfere with the study procedures and/or evaluations.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CV Fixed Dose Combination Pill AARCardiovascular Fixed Dose Combination Pill AARCardiovascular Fixed Dose Combination Pill AAR (acetylsalicylic acid 100 mg, atorvastatin 40 mg and ramipril 10 mg).
RamiprilRamipril 10 mgRamipril 10 mg (Altace®).
AtorvastatinAtorvastatin 40 mgAtorvastatin 40 mg (Lipitor®).
Primary Outcome Measures
NameTimeMethod
Difference in the adjusted mean 24-h systolic blood pressure results using ABPM between the baseline (week 0) and the final visit (week 8).Measures at baseline visit (week 0) and final visit (week 8).
Difference in LDL cholesterol levels between the baseline (week 4) and the final visit (week 8).Measures at baseline visit (week 4) and final visit (week 8).
Secondary Outcome Measures
NameTimeMethod
Difference in the adjusted mean 24-h diastolic blood pressure results (using ABPM) between the basal and the final visits.Measures at baseline visit (week 0) and final visit (week 8).
Difference in the adjusted mean 24-h mean arterial pressure results (using ABPM) between the basal and the final visits.Measures at baseline visit (week 0) and final visit (week 8).
Difference in the adjusted mean 24-h heart rate results (using ABPM) between the basal and the final visits.Measures at baseline visit (week 0) and final visit (week 8).
Difference in Very Low-Density Lipoprotein (VLDL) cholesterol levels between the basal and the final visits.Measures at baseline visit (week 0) and final visit (week 8).
Difference in HDL cholesterol levels between the basal and the final visits.Measures at baseline visit (week 0) and final visit (week 8).
Difference in total cholesterol levels between the basal and the final visits.Measures at baseline visit (week 0) and final visit (week 8).
Difference in triglyceride levels between the basal and the final visits.Measures at baseline visit (week 0) and final visit (week 8).
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]Through study completion, an average of 3 months.

AEs, clinical laboratory parameters (hematology, clinical chemistry, and urinalysis), vital signs, electrocardiogram (ECG), and physical examination.

The total number of patients with at least one AE and the number of AEs will be included in listings and tabulations. AEs will be coded using MedDRA, classified by system organ class (SOC) and preferred term and tabulated by intensity and causal relationship for each treatment.

Trial Locations

Locations (35)

Central Alabama Research

🇺🇸

Birmingham, Alabama, United States

Meridien Research

🇺🇸

St. Petersburg, Florida, United States

Diagnostics Research Group

🇺🇸

San Antonio, Texas, United States

The Chappel Group Research

🇺🇸

Kissimmee, Florida, United States

Cullen Research, LLC

🇺🇸

Houston, Texas, United States

Physician PrimeCare Research Institute, PLLC dba H

🇺🇸

San Antonio, Texas, United States

National Research Institute

🇺🇸

Los Angeles, California, United States

Infoshpere Clinical Research, Inc

🇺🇸

West Hills, California, United States

Clinical Trials Investigators, Inc

🇺🇸

Tustin, California, United States

PAB Clinical Research

🇺🇸

Brandon, Florida, United States

Clinical Therapeutics Corporation

🇺🇸

Coral Gables, Florida, United States

Moonshine Research Center, Inc

🇺🇸

Doral, Florida, United States

Riverside Clinical Research

🇺🇸

Edgewater, Florida, United States

Nova Clinical Research Center inc

🇺🇸

Hialeah, Florida, United States

Dr. John C. Gutleber Weight Loss, Beauty, and Family Practice

🇺🇸

Homestead, Florida, United States

Westside Center for Clinical Research

🇺🇸

Jacksonville, Florida, United States

Health Awareness, Inc.

🇺🇸

Jupitor, Florida, United States

Clinical Trials of America LA, LLC

🇺🇸

Monroe, Louisiana, United States

Sunrise Medical Center

🇺🇸

Lauderdale Lakes, Florida, United States

Cedar Crosse Research Center

🇺🇸

Chicago, Illinois, United States

Progressive Medical Research

🇺🇸

Port Orange, Florida, United States

Einstein Clinical Research

🇺🇸

Lancaster, South Carolina, United States

Punzi Medical Center

🇺🇸

Carrollton, Texas, United States

Clinical Research Source

🇺🇸

Perrysburg, Ohio, United States

Bay State Clinical Trials, Inc

🇺🇸

Watertown, Massachusetts, United States

Research Trials Worldwide LLC

🇺🇸

Humble, Texas, United States

Central Texas Health Research

🇺🇸

New Braunfels, Texas, United States

Deleon Research, PLLC

🇺🇸

Plano, Texas, United States

Sylvana Research

🇺🇸

San Antonio, Texas, United States

Chysalis Clinical Research

🇺🇸

St. George, Utah, United States

Clinical Research of South Florida

🇺🇸

Coral Gables, Florida, United States

Jacksonville Center for Clinical Research

🇺🇸

Jacksonville, Florida, United States

Clinical Trials Research

🇺🇸

Sacramento, California, United States

Louisville Metabolic and Atherosclerosis Research

🇺🇸

Louisville, Kentucky, United States

DelRicht Research

🇺🇸

New Orleans, Louisiana, United States

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