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    Clinical Trial Results:
    A randomized, multicenter, double-blind, 6 week study to evaluate the dose response of valsartan on blood pressure reduction in children 6 months-5 years old with hypertension, followed by a 2 week placebo withdrawal period.

    Summary
    EudraCT number
    2006-005261-19
    Trial protocol
    BE   DE   HU   FR   SE   PL   IT   GB  
    Global end of trial date
    21 Jan 2009

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Jul 2016
    First version publication date
    01 Aug 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CVAL489K2303
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00435162
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    CH-4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, +41 613241111,
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, +41 613241111,
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    21 Jan 2009
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    21 Jan 2009
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of the trial was to evaluate a dose dependent reduction in Mean Sitting Systolic Blood Pressure (MSSBP) when comparing three doses of valsartan (0.25 milligram/kilogram [mg/kg], 1 mg/kg and 4 mg/kg ) over a 6 week period in hypertensive children aged 6 months to 5 years.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Conference on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were followed.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    21 Mar 2007
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Poland: 10
    Country: Number of subjects enrolled
    Belgium: 11
    Country: Number of subjects enrolled
    France: 5
    Country: Number of subjects enrolled
    Hungary: 3
    Country: Number of subjects enrolled
    Italy: 2
    Country: Number of subjects enrolled
    India: 20
    Country: Number of subjects enrolled
    Brazil: 10
    Country: Number of subjects enrolled
    Turkey: 2
    Country: Number of subjects enrolled
    South Africa: 5
    Country: Number of subjects enrolled
    United States: 6
    Worldwide total number of subjects
    74
    EEA total number of subjects
    31
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    12
    Children (2-11 years)
    62
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study was conducted at 39 centers in 10 countries.

    Pre-assignment
    Screening details
    81 subjects were enrolled into single-blind period with placebo medication (min. 4 day, max. 28 days).75 subjects were randomized after screening period.One subject who was enrolled and included in randomized population was excluded from all analyses due to good clinical practice issues and is not counted in any table reported in this result record

    Period 1
    Period 1 title
    Period 1: Dose ranging
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Data analyst, Assessor
    Blinding implementation details
    The identity of the treatments was concealed by the use of study drugs that were all identical in packaging, labeling and schedule. Unblinding was allowed only in case of subjects emergencies and at the conclusion of the study.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Period 1: Low dose Valsartan
    Arm description
    Valsartan 0.25 milligram/kilogram (mg/kg) (low dose) oral suspension was administered once daily (OD) for 6 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    Valsartan Low dose
    Investigational medicinal product code
    VAL489
    Other name
    Pharmaceutical forms
    Suspension and effervescent granules for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Extemporaneous Valsartan 0.25 mg/kg (low dose) oral suspension administered OD for 6 weeks in period 1.

    Arm title
    Period 1: Medium dose Valsartan
    Arm description
    Valsartan 1.0 mg/kg(medium dose) oral suspension was administered OD for 6 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    Valsartan Medium dose
    Investigational medicinal product code
    VAL489
    Other name
    Pharmaceutical forms
    Suspension and effervescent granules for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Extemporaneous Valsartan 1.0 mg/kg(medium dose) oral suspension was administered OD for 6 weeks in period 1.

    Arm title
    Period 1: High dose Valsartan
    Arm description
    Valsartan 4.0 mg/kg(high dose) oral suspension was administered OD for 6 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    Valsartan High dose
    Investigational medicinal product code
    VAL489
    Other name
    Pharmaceutical forms
    Suspension and effervescent granules for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Extemporaneous Valsartan 4.0 mg/kg(high dose) oral suspension was administered OD for 6 weeks in period 1.

    Number of subjects in period 1
    Period 1: Low dose Valsartan Period 1: Medium dose Valsartan Period 1: High dose Valsartan
    Started
    30
    14
    30
    Completed
    30
    14
    30
    Period 2
    Period 2 title
    Period 2: Placebo withdrawal
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Data analyst, Assessor
    Blinding implementation details
    The identity of the treatments was concealed by the use of study drugs that were all identical in packaging, labeling and schedule. Unblinding was allowed only in case of subjects emergencies and at the conclusion of the study.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Period 2: Valsartan
    Arm description
    Valsartan oral suspension was administered OD for 2 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    Valsartan
    Investigational medicinal product code
    VAL489
    Other name
    Pharmaceutical forms
    Suspension and effervescent granules for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Extemporaneous Valsartan oral suspension was administered OD for 2 weeks in period 2.

    Arm title
    Period 2: Placebo
    Arm description
    Placebo matched to Valsartan oral suspension was administered OD for 2 weeks.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Suspension and effervescent granules for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo matched to Valsartan oral suspension was administered OD for 2 weeks in period 2.

    Number of subjects in period 2
    Period 2: Valsartan Period 2: Placebo
    Started
    36
    38
    Completed
    35
    38
    Not completed
    1
    0
         Adverse event, non-fatal
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Period 1: Low dose Valsartan
    Reporting group description
    Valsartan 0.25 milligram/kilogram (mg/kg) (low dose) oral suspension was administered once daily (OD) for 6 weeks.

    Reporting group title
    Period 1: Medium dose Valsartan
    Reporting group description
    Valsartan 1.0 mg/kg(medium dose) oral suspension was administered OD for 6 weeks.

    Reporting group title
    Period 1: High dose Valsartan
    Reporting group description
    Valsartan 4.0 mg/kg(high dose) oral suspension was administered OD for 6 weeks.

    Reporting group values
    Period 1: Low dose Valsartan Period 1: Medium dose Valsartan Period 1: High dose Valsartan Total
    Number of subjects
    30 14 30 74
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    3.4 ( 1.28 ) 3.2 ( 1.48 ) 3.3 ( 1.53 ) -
    Gender categorical
    Units: Subjects
        Female
    13 4 9 26
        Male
    17 10 21 48

    End points

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    End points reporting groups
    Reporting group title
    Period 1: Low dose Valsartan
    Reporting group description
    Valsartan 0.25 milligram/kilogram (mg/kg) (low dose) oral suspension was administered once daily (OD) for 6 weeks.

    Reporting group title
    Period 1: Medium dose Valsartan
    Reporting group description
    Valsartan 1.0 mg/kg(medium dose) oral suspension was administered OD for 6 weeks.

    Reporting group title
    Period 1: High dose Valsartan
    Reporting group description
    Valsartan 4.0 mg/kg(high dose) oral suspension was administered OD for 6 weeks.
    Reporting group title
    Period 2: Valsartan
    Reporting group description
    Valsartan oral suspension was administered OD for 2 weeks.

    Reporting group title
    Period 2: Placebo
    Reporting group description
    Placebo matched to Valsartan oral suspension was administered OD for 2 weeks.

    Primary: Change From Baseline in Mean Sitting Systolic Blood Pressure (MSSBP) at Week 6

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    End point title
    Change From Baseline in Mean Sitting Systolic Blood Pressure (MSSBP) at Week 6
    End point description
    Sitting blood pressure was measured using a calibrated standard sphygmomanometer after the subject remained in sitting position for 5 minutes at clinic during the visit. The repeat sitting measurements were made at 1-2 minute intervals and the mean of three sitting systolic blood pressure (SSBP) measurements were used as the average sitting office blood pressure for that visit. Change from baseline in MSSBP was evaluated. Analysis was performed in Intent-to-Treat (ITT) population defined as all randomized subjects who had both baseline and at least one post-baseline assessment of any efficacy variable.
    End point type
    Primary
    End point timeframe
    Baseline to Week 6
    End point values
    Period 1: Low dose Valsartan Period 1: Medium dose Valsartan Period 1: High dose Valsartan
    Number of subjects analysed
    30
    14
    30
    Units: millimeters of mercury (mmHg)
        arithmetic mean (standard deviation)
    -8.3 ( 10.44 )
    -10.3 ( 9.83 )
    -14.4 ( 10.93 )
    Statistical analysis title
    Change From Baseline in MSSBP at Week 6
    Statistical analysis description
    Slope was based on an ANCOVA model with terms including continuing prior antihypertensive therapy strata and race strata as factors, and centered baseline MSSBP and dose per body weight as continuous covariates.
    Comparison groups
    Period 1: High dose Valsartan v Period 1: Low dose Valsartan v Period 1: Medium dose Valsartan
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.099
    Method
    ANCOVA
    Parameter type
    Slope estimate
    Point estimate
    -1.05
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.31
         upper limit
    0.2
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.63

    Secondary: Change From Baseline in Mean Sitting Diastolic Blood Pressure (MSDBP) at Week 6

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    End point title
    Change From Baseline in Mean Sitting Diastolic Blood Pressure (MSDBP) at Week 6
    End point description
    Sitting blood pressure was measured using a calibrated standard sphygmomanometer after the subject remained in sitting position for 5 minutes at clinic during the visit. The repeat sitting measurements were made at 1-2 minute intervals and the mean of three SDBP measurements were used as the average sitting office blood pressure for that visit. Analysis was performed in ITT population.
    End point type
    Secondary
    End point timeframe
    Baseline to Week 6
    End point values
    Period 1: Low dose Valsartan Period 1: Medium dose Valsartan Period 1: High dose Valsartan
    Number of subjects analysed
    30
    14
    30
    Units: mmHg
        arithmetic mean (standard deviation)
    -4.7 ( 9.53 )
    -8.6 ( 12.43 )
    -6.7 ( 10.61 )
    No statistical analyses for this end point

    Secondary: Change From Week 6 in Mean Sitting Systolic Blood Pressure (MSSBP) at Week 8

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    End point title
    Change From Week 6 in Mean Sitting Systolic Blood Pressure (MSSBP) at Week 8
    End point description
    Sitting blood pressure was measured using a calibrated standard sphygmomanometer after the subject remained in sitting position for 5 minutes at clinic during the visit. The repeat sitting measurements were made at 1-2 minute intervals and the mean of three SSBP measurements were used as the average sitting office blood pressure for that visit. Analysis was performed in ITT population.
    End point type
    Secondary
    End point timeframe
    Week 6 to Week 8
    End point values
    Period 2: Valsartan Period 2: Placebo
    Number of subjects analysed
    35
    38
    Units: mmHg
        arithmetic mean (standard deviation)
    2.6 ( 8.38 )
    4.1 ( 9.66 )
    No statistical analyses for this end point

    Secondary: Change From Week 6 in Mean Sitting Diastolic Blood Pressure (MSDBP) at Week 8

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    End point title
    Change From Week 6 in Mean Sitting Diastolic Blood Pressure (MSDBP) at Week 8
    End point description
    Sitting blood pressure was measured using a calibrated standard sphygmomanometer after the subject remained in sitting position for 5 minutes at clinic during the visit. The repeat sitting measurements were made at 1-2 minute intervals and the mean of three SDBP measurements were used as the average sitting office blood pressure for that visit. Analysis was performed in ITT population.
    End point type
    Secondary
    End point timeframe
    Week 6 to Week 8
    End point values
    Period 2: Valsartan Period 2: Placebo
    Number of subjects analysed
    35
    38
    Units: mmHg
        arithmetic mean (standard deviation)
    1.8 ( 8.99 )
    3.4 ( 8.74 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events are collected from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV). All adverse events reported in this record are from date of First Patient First Treatment until Last Patient Last Visit
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    11.1
    Reporting groups
    Reporting group title
    Low Dose Valsartan in both periods
    Reporting group description
    Valsartan 0.25 mg/kg in both periods

    Reporting group title
    Low Dose Valsartan, then Placebo
    Reporting group description
    Valsartan 0.25 mg/kg in period 1, then placebo in period 2

    Reporting group title
    High Dose Valsartan, then Placebo
    Reporting group description
    Valsartan 4.0 mg/kg in period 1, then placebo in period 2

    Reporting group title
    Medium Dose Valsartan, then Placebo
    Reporting group description
    Valsartan 1.0 mg/kg in period 1, then placebo in period 2

    Reporting group title
    High Dose Valsartan in both periods
    Reporting group description
    Valsartan 4.0 mg/kg in both periods

    Reporting group title
    Medium Dose Valsartan in both periods
    Reporting group description
    Valsartan 1.0 mg/kg in both periods

    Serious adverse events
    Low Dose Valsartan in both periods Low Dose Valsartan, then Placebo High Dose Valsartan, then Placebo Medium Dose Valsartan, then Placebo High Dose Valsartan in both periods Medium Dose Valsartan in both periods
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    2 / 15 (13.33%)
    1 / 8 (12.50%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    0
    Gastrointestinal disorders
    Enteritis
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastritis
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Bronchospasm
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 8 (12.50%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Nephrotic syndrome
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Respiratory tract infection
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Low Dose Valsartan in both periods Low Dose Valsartan, then Placebo High Dose Valsartan, then Placebo Medium Dose Valsartan, then Placebo High Dose Valsartan in both periods Medium Dose Valsartan in both periods
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    8 / 15 (53.33%)
    10 / 15 (66.67%)
    11 / 15 (73.33%)
    4 / 8 (50.00%)
    9 / 15 (60.00%)
    3 / 6 (50.00%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    1 / 15 (6.67%)
    0 / 6 (0.00%)
         occurrences all number
    0
    2
    0
    0
    1
    0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    3 / 15 (20.00%)
    0 / 8 (0.00%)
    2 / 15 (13.33%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    3
    0
    2
    0
    Ear and labyrinth disorders
    Otorrhoea
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 8 (12.50%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    0
    1
    0
    0
    Immune system disorders
    Allergy to arthropod bite
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 8 (12.50%)
    1 / 15 (6.67%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    0
    1
    1
    0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 15 (6.67%)
    2 / 15 (13.33%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    2 / 15 (13.33%)
    0 / 6 (0.00%)
         occurrences all number
    2
    2
    3
    0
    4
    0
    Aphthous stomatitis
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Cheilitis
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Constipation
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    0
    0
    0
    1
    Diarrhoea
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    2 / 15 (13.33%)
    0 / 8 (0.00%)
    2 / 15 (13.33%)
    0 / 6 (0.00%)
         occurrences all number
    0
    1
    3
    0
    2
    0
    Nausea
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Vomiting
         subjects affected / exposed
    3 / 15 (20.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    3
    0
    1
    0
    0
    1
    Respiratory, thoracic and mediastinal disorders
    Asthmatic crisis
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 8 (12.50%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    0
    1
    0
    0
    Cough
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 8 (12.50%)
    2 / 15 (13.33%)
    0 / 6 (0.00%)
         occurrences all number
    1
    0
    0
    1
    2
    0
    Increased upper airway secretion
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 8 (12.50%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    0
    1
    0
    0
    Rhinorrhoea
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    1
    0
    2
    0
    0
    0
    Skin and subcutaneous tissue disorders
    Dermatitis
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Dermatitis bullous
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Dermatitis diaper
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    0
    Dry skin
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Pruritus
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Rash
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    1
    1
    0
    0
    0
    Pruritus generalised
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    0
    Urticaria
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    1
    0
    1
    0
    0
    0
    Infections and infestations
    Acute tonsillitis
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Bronchitis
         subjects affected / exposed
    1 / 15 (6.67%)
    1 / 15 (6.67%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    1 / 15 (6.67%)
    0 / 6 (0.00%)
         occurrences all number
    1
    2
    1
    0
    2
    0
    Gastroenteritis
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    1
    0
    0
    0
    0
    Gastroenteritis viral
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 8 (12.50%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    0
    1
    0
    0
    Impetigo
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Nasopharyngitis
         subjects affected / exposed
    2 / 15 (13.33%)
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    2
    1
    0
    0
    0
    1
    Pharyngitis
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    1 / 8 (12.50%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    1
    0
    1
    0
    0
    Pharyngotonsillitis
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Rhinitis
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    2
    0
    0
    0
    0
    Scarlet fever
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Tonsillitis
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 15 (6.67%)
    3 / 15 (20.00%)
    2 / 15 (13.33%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    1
    3
    2
    0
    0
    0
    Urinary tract infection
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    0 / 15 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    1
    0
    1
    0
    0
    0
    Varicella
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    1 / 15 (6.67%)
    0 / 6 (0.00%)
         occurrences all number
    0
    1
    0
    0
    1
    0
    Metabolism and nutrition disorders
    Hyperkalaemia
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    1 / 15 (6.67%)
    0 / 8 (0.00%)
    2 / 15 (13.33%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    1
    0
    2
    0
    Hypertriglyceridaemia
         subjects affected / exposed
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 15 (0.00%)
    0 / 8 (0.00%)
    1 / 15 (6.67%)
    0 / 6 (0.00%)
         occurrences all number
    0
    0
    0
    0
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    26 Jul 2007
    Deleted inclusion criterion allowing subjects with previous solid organ transplantation more than 1 year ago and rephrased to exclude solid organ transplantation < 1 year ago. Exclusion criterion was changed to allow enrolment of subjects with electrocardiogram (ECG) abnormalities associated with left ventricular hypertrophy. Further, cardiac insufficiency was added to the list of examples of clinically significant ECG abnormalities considered exclusionary. Exclusion criterion was revised and deleted the renal artery stenosis. Unilateral, bilateral and graft renal artery stenosis was added to the exclusion criterion. Specified that a decrease in estimated glomerular filtration rate (GFR) from baseline by more than 50% required discontinuation from the study. Specified that an Ora-plus and Ora-sweet preparation (not Ora-Blend) was used to prepare the extemporaneous suspension of valsartan. Acute dehydration and hyperkalemia were added to the requirements for discontinuation of study drug. The section describing the process for collecting information on screening failures was simplified. A description of the collection and reporting of suspected, unexpected serious adverse event (SUSARs) was added to the section on serious adverse event reporting.
    30 Sep 2008
    Lowered the age limit from 1 year to 6 months old for entry criteria into the study ( EMA request) Included recommendation of External Safety Monitoring Committee ( ESMC) to enhance monitoring of liver function, renal function and serum potassium alert in all patients The screening period was started with Day -28. Inclusion criterion was elaborated in order to state that for all subjects, mean seated systolic blood pressure had to be equal to or greater than 95th percentile at randomization. Exclusion criterion was further revised to exclude subjects with previous solid organ transplantation less < 1 year prior to Visit 1.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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