E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Hyperactivity of the brain renin-angiotensin system participates to the development and maintenance of essential Hypertension |
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E.1.1.1 | Medical condition in easily understood language |
Treatment of essential hypertension |
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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 | 18.0 |
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 assess the BP lowering effect of 4-week administration of QGC001 oral doses in patients with grade I or II essential hypertension compared to placebo. |
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E.2.2 | Secondary objectives of the trial |
•To assess the safety and tolerability of 4-week administration of QGC001 oral doses in patients with grade I or II essential hypertension compared to placebo
•To obtain preliminary PK information for QGC001 given as multiple oral doses
•To determine preliminary PD profile of QGC001 multiple oral doses on plasma and urine hormones, which will be compared to that of placebo.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Male and female of non-childbearing potential patients (post-menopausal since at least 12 months or surgically sterilized) aged 18 to 75 years of age;
2. Body weight ≥50 kg with a body mass index (BMI) calculated as weight in kg/(height in m2) from 18 to 40 kg/m2 at screening;
3. A signed and dated informed consent form before any study-specific screening procedure is performed;
4. With a diagnosis of essential grade I or II hypertension defined as:
• a supine office systolic BP (SBP) of 140–159 mmHg or diastolic BP (DBP) of 90–99 mmHg who should have an additional clinical indication for antihypertensive treatment according to ESH guidelines after a 2-week placebo run-in period,
• or a supine office SBP of 160-179 mmHg or DBP of 100–109 mmHg after a 2-week placebo run-in period with a diagnosis of essential grade II hypertension;
5. The diagnosis of permanent hypertension will be confirmed by a mean SBP or DBP higher than 135 or 85 mmHg on daytime ambulatory blood pressure monitoring (ABPM) after a 2-week placebo run-in period;
6. Estimated glomerular filtration rate (Modification of Diet in Renal Disease (MDRD) formula) ≥ 60 ml/min/1.73 m2. |
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E.4 | Principal exclusion criteria |
1. Any significant hepatic, renal, respiratory (e.g., asthma), gastrointestinal, endocrine (e.g., diabetes, dyslipidemia necessitating drug therapy), immunologic, dermatological, hematological, neurologic, psychiatric disease or history of any clinically important drug
allergy;
2. Acute disease state (e.g., vomiting, fever, diarrhea) within 7 days before study day 1;
3. History of transient ischemic accident (TIA) or cerebrovascular accident (CVA) during the 6 months prior to screening;
4. History of acute heart failure or heart failure (NYHA class II-IV) within the 6 months prior to screening;
5. History of myocardial infarction, unstable angina, coronary bypass or percutaneous coronary angioplasty during the 6 months prior to screening;
6. History of malignant tumor during the past 5 years;
7. Any medical or surgical disorder considered by the investigator as increasing the risks of participation in the study, or liable to prevent the patient from complying with the equirements of the study or from continuing the study to completion;
8. Any situation which, in the investigator's opinion, might compromise assessment of efficacy or of safety;
9. History of non-adherence to treatment;
10. History of drug abuse within 1 year before study day 1;
11. History of alcoholism within 1 year before day 1;
12. Positive serologic findings for human immunodeficiency virus (HIV) antibodies, hepatitis Bsurface antigen (HBsAg), and/or hepatitis C virus (HCV) antibodies;
13. Use of any investigational drug within 30 days before IMP administration;
14. Donation of blood (i.e., 500 ml) within 90 days before study day 1;
15. Known secondary hypertension;
16. Grade III hypertension;
17. Estimated glomerular filtration rate (MDRD formula) below 60 ml/min/1.73 m2;
18. Type I diabetes mellitus or uncontrolled type II diabetes mellitus (HbA1C ≥ 10%);
19. Severe obesity (BMI ≥ 40 kg/m2);
20. Arm circumference ≥ 42 cm;
21. Atrial fibrillation;
22. Known hypersensitivity to drugs;
23. History of spontaneous or drug induced angioneurotic edema;
24. Use of any medication of the following medications within the four (4) weeks prior to dosing.
• Thyroid medication, statin therapy, oral antidiabetic drugs, estrogen replacement therapy and/or chronic low dose aspirin (75 mg/day) unless the patient has been on a stable maintenance dose for at least 3 months prior to screening.
• Anticoagulant treatments
• Cholestyramine resins.
• Treatment with oral, topical, inhaled, eye drop corticosteroids
• Treatment with class Ia, Ib and Ic or III anti-arrhythmics
• CNS drugs
• P-glycoprotein (P-gp) inhibitors (e.g., verapamil, quinidine, ritonavir),
• known cytochrome P450 inducers or inhibitors (eg, ketoconazole/CYP3A4,quinidine/CYP2D6, gemfibrozil/CYP2C8)
• Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDS) or cyclooxygenase(COX)-2 inhibitors
• Vasodilators or vascular muscle relaxants prescribed for other conditions
25. Unlikely to cooperate in the study and/or poor compliance anticipated by the investigator,e.g., uncooperative attitude, inability to return for follow-up visit, and unlikelihood of completing the study;
26. Participation in another interventional study at the same time or within 3 months prior to the beginning of the present study;
27. Participant not affiliated with the French social security;
28. No written informed consent. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint will be comparison of change from baseline of daytime mean systolic blood pressure (SBP) as calculated from the ambulatory blood pressure measurement (ABPM) after 4 weeks of treatment of QGC001 or placebo. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
The secondary efficacy endpoints will be comparisons between treatments (QGC001 versus placebo) on the following parameters:
• Office SBP and diastolic blood pressure (DBP) measured at trough,
• 24h mean SBP/DBP, daytime DBP and night-time SBP/DBP, systolic and diastolic load. The 24h systolic and diastolic loads will be calculated as the proportion of time, expressed as percentages, that the ambulatory systolic and diastolic BPs will be elevated during the daytime (> 130/80 mmHg) or during the night-time (> 120/80 mmHg).
• The time course of the effect will be examined through home BP response every two weeks.
• We will also use ABPM to calculate the median trough to peak ratios and their 95%CIs for QGC001.
The pharmacokinetic endpoints will be the concentrations of QGC001 and its metabolite EC33.
The pharmacodynamic neurohormonal endpoints will be the concentrations of plasma active renin, aldosterone, cortisol, ACTH and copeptin as well as urine aldosterone, cortisol, creatinine,apelin .
The safety endpoints will be assessed through:
- Adverse events,
- Biological examinations: haematology, biochemistry (blood and urinary),
- Physical examination with weight assessment (kg) and body temperature (°C),
- Vital signs (supine and standing BP and HR from office measurements)
- 12-lead ECG. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
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 | Yes |
E.6.13.1 | Other scope of the trial description |
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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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 | Yes |
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 | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | No |
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 | No |
E.8.7 | Trial has a data monitoring committee | Yes |
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 | |
E.8.9.1 | In the Member State concerned months | 16 |
E.8.9.1 | In the Member State concerned days | |