E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 6.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10020772 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Evaluate the efficacy in blood pressure control when anti-hypertensive therapy is initiated with a combination of low dose Nifedipine GITS and Telmisartan compared to a regimen starting with monotherapy before adding the other drug. |
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E.2.2 | Secondary objectives of the trial |
The effect of treatment on the metabolic and inflammation markers as indicators of cardiovascular risk will also be assessed. |
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
- Hypertension (office systolic blood pressure > 135 mmHg), untreated or poorly controlled but stable antihypertensive regimen for >= 4 weeks - Presence of type 2 diabetes mellitus or target organ damage (echocardiographic or electrocardiographic left ventricular hypertrophy or microalbuminuria ) - Presence of a metabolic syndrome, i.e at least two of the following: (a) impaired glucose tolerance (fasting plasma glucose 110 ヨ 125 mg/dl) (b) raised serum triglycerides (>= 150 mg/dl) (c) low HDL cholesterol (males: < 40 mg/dl, females: < 50 mg/dl) (d) waist circumference >102 cm in men and >88 cm in women - Age: 18-75 years - Negative pregnancy test in females - Written informed consent |
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E.4 | Principal exclusion criteria |
- Ongoing treatment with the following drugs: ACE-inhibitors (e.g. captopril, benazepril, enalapril, lisinopril, fosinopril, ramipril, perindopril, quinapril, moexipril, and trandolapril), AT1-antagonists (e.g. losartan, candesartan, eprosartan, telmisartan) or calcium-antagonists (e.g. amlodipine, felodipine, isradipine, nifedipine, nimodipine) that cannot be withdrawn. - Concomitant treatment with other antihypertensive medication that cannot be safely withdrawn at entry. - Concomitant treatment with known cytochrome P450-3A4 inhibitors (e.g cimetidine, anti-HIV protease inhibitors e.g. ritonavir, azole anti-mycotics eg. Ketoconazole, digoxin, quinidine, tacrolimus) or inducers such as anti-epileptic drugs (eg. phenytoin, carbamazepine and phenobarbitone) or rifampicin - Concomitant treatment with potassium sparing diuretics. - Malignant, severe or labile essential hypertension, orthostatic hypotension - Cardiovascular shock - Evidence of secondary form of hypertension, including coarctation of the aorta, hyperaldosteronism, renal artery stenosis or pheochromocytoma - Myocardial infarction or unstable angina within the previous 12 months - Severe cardiac valve disease - Severe rhythm or conduction disorder: - bradycardia on physical examination at rest (HR < 50/min) - tachycardia on physical examination at rest (HR > 100/min) - frequent complex ventricular arrythmias - atrial fibrillation - intraventricular conduction disorders, Wolf Parkinson White syndrome - sino-atrial, second degree or third degree A-V block - baseline QTc > 450 msec - Cerebrovascular ischaemic event (stroke, transient ischaemic attack) within the previous 12 months - History of intra-cerebral haemorrhage or sub-arachnoid haemorrhage within the previous 12 months - Type 1 diabetes mellitus - Proteinuria (determined by uristix) - BMI > 34 - Uncorrected hypokalemia or hyperkalemia, potassium outside the range 3.0 to 5.5 mmol/l - Sodium depletion and/or hypovolemia - Gastrointestinal disease resulting in the potential for malabsorption. - Severe gastrointestinal tract narrowing - Kock pouch (ileostomy after proctocolectomy) - Cholestasis or biliary obstruction - Liver disease or transaminase (AST, ALT) levels > 3 x the upper limit of normal range. - Renal failure, creatinine >2.0 mg/dl - Any malignant disease that has required treatment within the last five years. - Dementia or psychosis. - History of non-compliance, alcoholism or drug abuse. - Treatment with any other investigational drug in the 30 days prior to entering the study. - Pregnancy and lactation - Known state of allergy, hypersensitivity to nifedipine or any other dihydropyridine or to telmisartan - Any surgical or medical condition which, at the discretion of the investigator, place the subject at higher risk from his/her participation in the study or are likely to prevent the subject from complying with the requirements of the study or completing the trial period. - History of non compliance to medical regimens or subjects unwilling to comply with the study protocol. |
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E.5 End points |
E.5.1 | Primary end point(s) |
La valutazione dellメend-point sara' effettuata in cieco. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Information not present in EudraCT |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
stessi farmaci in associazione |
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E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 2 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 2 |