E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
Patients with high blood pressure |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cardiovascular Diseases [C14] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10015488 |
E.1.2 | Term | Essential hypertension |
E.1.2 | System Organ Class | 10047065 - Vascular disorders |
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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 |
To evaluate the blood pressure lowering effect and safety of LCZ696 when given alone and in combination with amlodipine in patients with essential hypertension. |
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E.2.2 | Secondary objectives of the trial |
1.evaluate efficacy of LCZ696 compared to placebo, measured by change in mean sitting BP (msDBP) from BS after 8 weeks treatment in patients with essential HT.
2.evaluate efficacy of combination of LCZ696 and amlodipine compared to monotherapy, measured by change msDBP from BS after 8 weeks treatment in pts with essential HT.
3.evaluate office and ambulatory pulse pressure for all trtment groups after 8 wks trtment.
4.evaluate efficacy of LCZ696 compared to placebo, measured by change in mean 24-hour ambulatory (maSBP), mean 24-hour ambulatory (maDBP), daytime and nighttime maSBP/maDBP, trough/peak ratios of maSBP and maDBP from baseline after 8 wks trtment in a subset of patients with essential HT.
5.evaluate efficacy of combination of LCZ696 and amlodipine compared to monotherapy, measured by change in mean 24-hour ambulatory maSBP), mean 24-hour ambulatory (maDBP), daytime and nighttime maSBP/maDBP from baseline after 8 weeks treatment in a subset of patients with essential HT. |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
ABPM Sub-study
Objectives:
To evaluate the efficacy of LCZ696 200mg and 400mg compared to placebo, as measured by change in mean 24-hour ambulatory SBP (maSBP), mean 24-hour ambulatory DBP(maDBP), daytime and nighttime maSBP/maDBP, trough/peak ratios of maSBP and maDBP from baseline after 8 weeks of treatment in a subset of patients with essential hypertension.
To evaluate the efficacy of combination of LCZ696 and amlodipine (200/5mg, 200/10mg, 400/5mg and 400/10 mg) compared to monotherapy, as measured by change in mean 24-hour ambulatory SBP
(maSBP), mean 24-hour ambulatory DBP (maDBP), daytime and nighttime maSBP/maDBP from baseline after 8 weeks of treatment in a subset of patients with essential hypertension. |
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E.3 | Principal inclusion criteria |
1.Male or female outpatients.
2.Patients with mild-to- moderate hypertension, untreated or currently taking antihypertensive therapy.
3.Treated patients (using antihypertensive treatments within 4 weeks prior to Visit 1)
must have an msSBP ≥150 mmHg and<180 mmHg at the randomization visit and msSBP ≥140 mmHg <180 mmHg at the preceding visit.
4.Untreated patients (newly diagnosed with essential hypertension or having a history of hypertension but have not been taking any antihypertensive drugs for at least 4 weeks prior to Visit 1) must have an msSBP ≥150.mmHg and <180 mmHg at both the randomization visit and the preceding visit.
5.Patients must have an absolute difference of ≤15 mmHg in msSBP between the randomization visit and the preceding visit.
6.Ability to communicate and comply with all study requirements and demonstrate good medication compliance (≥ 80% compliance rate) during the treatment run-in period. |
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E.4 | Principal exclusion criteria |
1.Severe hypertension (msDBP ≥110 mmHg and/or msSBP ≥ 180 mmHg).
2.History of angioedema, drug- related or otherwise.
3.History or evidence of a secondary form of hypertension, including but not limited to any of the following: renal parenchymal hypertension, renovascular hypertension (unilateral or bilateral renal artery stenosis), coarctation of the aorta, primary hyperaldosteronism, Cushing’s disease, pheochromocytoma, polycystic kidney disease, and drug- induced hypertension.
4.Transient ischemic cerebral attack (TIA) during the 12 months prior to Visit 1 or any history of stroke.
5.History of myocardial infarction, coronary bypass surgery or any percutaneous coronary intervention (PCI) during the 12 months prior to Visit 1.
6.Pregnant or lactating women.
7.Women of child-bearing potential not using highly effective methods of contraception. |
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E.5 End points |
E.5.1 | Primary end point(s) |
1.Change from baseline in mean sitting systolic blood pressure (msSBP) of LCZ696 monotherapy compared to placebo.
2.Change from baseline in mean sitting systolic blood pressure (msSBP) of the combination of LCZ696 and amlodipine compared to LCZ696 and amlodipine alone. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1.at baseline, 8 weeks
2.at baseline, 8 weeks |
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E.5.2 | Secondary end point(s) |
1. To evaluate the efficacy of LCZ696 200mg and 400mg compared to placebo, as measured by change in mean sitting diastolic BP (msDBP) from baseline after 8 weeks of treatment in patients with essential hypertension.
2. To evaluate the efficacy of combination of LCZ696 and amlodipine (200/5mg, 200/10mg, 400/5mg and 400/10 mg) compared to monotherapy, as measured by change in msDBP from baseline after 8 weeks of treatment in patients with essential hypertension.
3. To evaluate office and ambulatory pulse pressure for all treatment groups after 8 weeks of treatment.
4. To evaluate the efficacy of LCZ696 200mg and 400mg compared to placebo, as measured by change in mean 24-hour ambulatory SBP (maSBP), mean 24-hour ambulatory DBP (maDBP), daytime and nighttime maSBP/maDBP, trough/peak ratios of maSBP and maDBP from baseline after 8 weeks of treatment in a subset of patients with essential hypertension.
5. To evaluate the efficacy of combination of LCZ696 and amlodipine (200/5mg, 200/10mg, 400/5mg and 400/10 mg) compared to monotherapy, as measured by change in mean 24-hour ambulatory SBP (maSBP), mean 24-hour ambulatory DBP (maDBP), daytime and nighttime maSBP/maDBP from baseline after 8 weeks of treatment in a subset of patients with essential hypertension.
6. To assess the proportion of patients achieving blood pressure control (msSBP<140 mmHg and msDBP <90 mmHg) for all treatment groups after 8 weeks of treatment.
7. To assess the proportion of patients achieving a successful response in msSBP (< 140 mmHg or a reduction ≥ 20 mmHg from baseline) for all treatment groups after 8 weeks of treatment.
8. To assess the proportion of patients achieving a successful response (msDBP < 90 mmHg or a reduction ≥ 10 mmHg from baseline) for all treatment groups after 8 weeks of treatment.
9. To evaluate the safety of LCZ696 and its combination with amlodipine (200/5mg, 200/10mg, 400/5mg and 400/10 mg) in patients with essential hypertension. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. from baseline after 8 weeks of treatment.
2. from baseline after 8 weeks of treatment.
3. after 8 weeks of treatment.
4. from baseline after 8 weeks of treatment.
5. from baseline after 8 weeks of treatment.
6. after 8 weeks of treatment.
7. after 8 weeks of treatment.
8. after 8 weeks of treatment.
9. after 8 weeks of treatment. |
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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 | No |
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 | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
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) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
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 | No |
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) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 9 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 11 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 19 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Argentina |
Brazil |
Colombia |
Dominican Republic |
Ecuador |
Guatemala |
Mexico |
Panama |
Peru |
Philippines |
Russian Federation |
Slovakia |
South Africa |
Spain |
Thailand |
Vietnam |
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E.8.7 | Trial has a data monitoring committee | No |
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 | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |