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HypertensionPhase 3ACCOMPLISHNCT00170950

Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension

A Phase 3 study testing Benazepril/amlodipine 20/5 mg - Dose Level 1 from Day 1 to Month 1, Benazepril/amlodipine 40/5 mg - Dose Level 2 from Month 1 to Month 2 and Benazepril/amlodipine 40/10 mg - Dose Level 3 from Month 2 to Month 3 and thereafter in people with Hypertension, run by Novartis at 5 sites in 5 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

A comparison study of two combination drugs, amlodipine/benazepril and benazepril/HCTZ to evaluate the effectiveness of the combination on reducing heart disease and death in a high risk hypertensive population. Read more about this study

Who is it for?
Ages 55 years and older
Conditions the study is for
Hypertension
What is being tested?
Benazepril/amlodipine 20/5 mg - Dose Level 1 from Day 1 to Month 1, Benazepril/amlodipine 40/5 mg - Dose Level 2 from Month 1 to Month 2 and Benazepril/amlodipine 40/10 mg - Dose Level 3 from Month 2 to Month 3 and thereafter
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
11,506 participants
Where
5 sitesin 5 countries
Study dates
Oct 2003to May 2008
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 55 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • At least 55 years of age.
  • Previously untreated or treated hypertension.
  • For patients >= 60 years, evidence of at least one CV disease or target organ damage, or for patients 55-59 years evidence of at least two CV diseases or target organ damage from two different organ systems as defined in the protocol.

Who cannot join

  • Allergy to any of the drugs administered in this trial.
  • Current angina pectoris (ie, no anginal event requiring NTG within 1 month prior to Visit 1).
  • Secondary hypertension.
  • Refractory hypertension defined as SBP >= 180 mmHg and/or DBP >= 110 mmHg unresponsive to triple-drug regimens of sympatholytics, diuretics and vasodilators.
  • History of symptomatic heart failure (NYHA classes II-IV) or ejection fraction < 40%.
  • Myocardial infarction, coronary revascularization (CABG or PCI), unstable angina within one month of Visit 1.
Show all 16Show fewer
  • Stroke or transient ischemic event (TIA) within 3 months of Visit 1.
  • Significant obstructive valvular cardiovascular disease or any valvular disease expected to lead to surgery during the course of the study.
  • Evidence of hepatic disease (AST or ALT values >= 2 X upper limit of normal).
  • Impaired renal function (serum creatinine >= 2.5 mg/dL (221 µmol/L)).
  • Baseline serum potassium of > 5.2 meq/L not on potassium supplements.
  • History of malignancy including leukemia and lymphoma (but not basal cell skin cancer) within the last 5 years.
  • History of clinically significant auto immune disorders such as Systemic Lupus Erythematosus.
  • Significant non-cardiovascular illness or condition likely to result in death prior to trial completion, e.g., major organ transplant (life expectancy <5 years).
  • Significant cardiovascular disease such as an aortic aneurysm ≥ 6 cm, likely requiring surgical intervention during the course of the study.
  • Other protocol-defined exclusion criteria applied to the study.

Trial locations and contacts

5 sites in 5 countries.

5 sites in 5 countries

United States1 site
  • Novartis Pharmaceuticals

    East Hanover, New Jersey, 07936

Other trials in United States

Denmark1 site
  • sites in Denmark

    Denmark

Other trials in Denmark

Finland1 site
  • sites in Finland

    Finland

Other trials in Finland

Norway1 site
  • sites in Norway

    Norway

Other trials in Norway

Sweden1 site
  • sites in Sweden

    Sweden

Other trials in Sweden

About this study

Official title: A Prospective, Multinational, Multicenter Trial to Compare the Effects of Amlodipine/Benazepril to Benazepril and Hydrochlorothiazide Combined on the Reduction of Cardiovascular Morbidity and Mortality in Patients With High Risk Hypertension

A comparison study of two combination drugs, amlodipine/benazepril and benazepril/HCTZ to evaluate the effectiveness of the combination on reducing heart disease and death in a high risk hypertensive population.

Conditions
Hypertension
Being tested
Benazepril/amlodipine 20/5 mg - Dose Level 1 from Day 1 to Month 1, Benazepril/amlodipine 40/5 mg - Dose Level 2 from Month 1 to Month 2, Benazepril/amlodipine 40/10 mg - Dose Level 3 from Month 2 to Month 3 and thereafter, Benazepril/hydrochlorothiazide 20/12.5 mg - Dose Level 1 from Day 1 to Month 1, Benazepril/hydrochlorothiazide 40/12.5 mg - Dose Level 2 from Month 1 to Month 2
Keywords
cardiovascular morbidity, cardiovascular mortality, benazepril, amlodipine, high risk population
Medical subject headings
Hypertension

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Benazepril/amlodipine 20/5 mg - Dose Level 1 from Day 1 to Month 1Drug

    Benazepril hydrochloride (HCl)/amlodipine besylate 10/5 mg capsules for oral administration once daily.

  • Benazepril/amlodipine 40/5 mg - Dose Level 2 from Month 1 to Month 2Drug

    Benazepril hydrochloride (HCl)/amlodipine besylate 20/5 mg capsules for oral administration once daily.

  • Benazepril/amlodipine 40/10 mg - Dose Level 3 from Month 2 to Month 3 and thereafterDrug

    Benazepril hydrochloride (HCl)/amlodipine besylate: 40/10 mg capsules for oral administration once daily. Patients titrated to this dose level had the possibility of subsequent free add-on antihypertensive agents after month 3 based on target blood pressure.

  • Benazepril/hydrochlorothiazide 20/12.5 mg - Dose Level 1 from Day 1 to Month 1Drug

    Benazepril hydrochloride (HCl)/hydrochlorothiazide (HCTZ) 20/12.5 mg capsules for oral administration once daily.

  • Benazepril/hydrochlorothiazide 40/12.5 mg - Dose Level 2 from Month 1 to Month 2Drug

    Benazepril hydrochloride (HCl)/hydrochlorothiazide (HCTZ) 40/12.5 mg capsules for oral administration once daily.

  • Benazepril/hydrochlorothiazide 40/25 mg - Dose Level 3 from Month 2 to Month 3 and thereafterDrug

    Benazepril hydrochloride (HCl)/hydrochlorothiazide (HCTZ) 40/25 mg capsules for oral administration once daily. Patients titrated to this dose level had the possibility of subsequent free add-on antihypertensive agents after month 3 based on target blood pressure.

Study groups in NCT00170950
Study groupRoleWhat they receive
Benazepril/amlodipineExperimentalPatients were instructed to take one capsule with water in the morning, except on the morning of their next office visit. On office visit days, study medication was taken after completion of the visit evaluations. Following randomization, all patients were treated at Dose Level 1 for 4 weeks, followed by a forced titration to Dose Level 2 for a subsequent 4 week period. Thereafter, patients were titrated as needed to Dose Level 3 to achieve a target blood pressure of < 140/< 90 mm Hg. For patients with diabetes or chronic kidney disease, investigators were encouraged to use a target blood pressure of 130/80 mm Hg.
Receives: Drug: Benazepril/amlodipine 20/5 mg - Dose Level 1 from Day 1 to Month 1; Drug: Benazepril/amlodipine 40/5 mg - Dose Level 2 from Month 1 to Month 2; Drug: Benazepril/amlodipine 40/10 mg - Dose Level 3 from Month 2 to Month 3 and thereafter
Benazepril/hydrochlorothiazideActive comparatorPatients were instructed to take one capsule with water in the morning, except on the morning of their next office visit. On office visit days, study medication was taken after completion of the visit evaluations. Following randomization, all patients were treated at Dose Level 1 for 4 weeks, followed by a forced titration to Dose Level 2 for a subsequent 4 week period. Thereafter, patients were titrated as needed to Dose Level 3 to achieve a target blood pressure of < 140/< 90 mm Hg. For patients with diabetes or chronic kidney disease, investigators were encouraged to use a target blood pressure of 130/80 mm Hg.
Receives: Drug: Benazepril/hydrochlorothiazide 20/12.5 mg - Dose Level 1 from Day 1 to Month 1; Drug: Benazepril/hydrochlorothiazide 40/12.5 mg - Dose Level 2 from Month 1 to Month 2; Drug: Benazepril/hydrochlorothiazide 40/25 mg - Dose Level 3 from Month 2 to Month 3 and thereafter

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time-to-event Analysis of Percentage of Patients With a Composite Cardiovascular (CV) Morbidity or Mortality Event

    CV morbidity was defined as non-fatal myocardial infarction (MI), non-fatal stroke, hospitalization for unstable angina, resuscitated sudden death, or coronary revascularization procedure. CV mortality was defined as death due to MI, stroke, coronary intervention, congestive heart failure (CHF), sudden cardiac death, or other CV causes.

    Measured: For each patient, baseline to time of first CV morbidity or mortality event (or last exposure if no event occurred). (Median duration of exposure was 33.4 months. [25th to 75th percentiles: 21 to 41 months.])

Secondary outcomes (2)
  1. Time-to-event Analysis of Percentage of Patients With a Composite Cardiovascular (CV) Morbidity Event

    Cardiovascular morbidity was defined as including any of the following events: non-fatal MI, non-fatal stroke, hospitalization for unstable angina, resuscitated sudden death, or coronary revascularization procedure (PCI or CABG).

    Measured: For each patient, baseline to time of first CV morbidity event (or last exposure if no event occurred). (Median duration of exposure was 33.4 months. [25th to 75th percentiles: 21 to 41 months.])]

  2. Time-to-event Analysis of Percentage of Patients With a Cardiovascular (CV) Mortality Event, Non-fatal Myocardial Infarction (MI), or Non-fatal Stroke

    CV mortality was defined as death due to sudden cardiac death, fatal MI, fatal stroke, coronary intervention, congestive heart failure (CHF), or other CV causes.

    Measured: For each patient, baseline to time of first CV mortality event, MI (non-fatal), or stroke (non-fatal) (or last exposure if no event occurred). (Median duration of exposure was 33.4 months. [25th to 75th percentiles: 21 to 41 months.])

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Sep 2005 (estimated)
  2. Study startOct 2003
  3. Primary completionJan 2008
  4. Study completionMay 2008

Why it stopped: The study was terminated early because of significant efficacy results for the primary endpoint in favor of benazepril/amlodipine treatment.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
11,506 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00170950
Sponsor's protocol ID
CCIB002I2301
Acronym
ACCOMPLISH
Status last verified
Oct 2023
First submitted
10 Sep 2005
Last updated
24 Oct 2023

Publications

  • Jamerson K, Weber MA, Bakris GL, Dahlof B, Pitt B, Shi V, Hester A, Gupte J, Gatlin M, Velazquez EJ; ACCOMPLISH Trial Investigators. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med. 2008 Dec 4;359(23):2417-28. doi: 10.1056/NEJMoa0806182.

    PubMed 19052124
  • Brook RD, Kaciroti N, Bakris G, Dahlof B, Pitt B, Velazquez E, Weber MA, Jamerson KA. Cardiovascular Benefits of Angiotensin-Converting Enzyme Inhibition Plus Calcium Channel Blockade in Patients Achieving Tight Blood Pressure Control and With Resistant Hypertension. Am J Hypertens. 2021 May 22;34(5):531-539. doi: 10.1093/ajh/hpaa192.

    PubMed 33216879
  • Weber MA, Jamerson K, Bakris GL, Weir MR, Zappe D, Zhang Y, Dahlof B, Velazquez EJ, Pitt B. Effects of body size and hypertension treatments on cardiovascular event rates: subanalysis of the ACCOMPLISH randomised controlled trial. Lancet. 2013 Feb 16;381(9866):537-45. doi: 10.1016/S0140-6736(12)61343-9. Epub 2012 Dec 6.

    PubMed 23219284
  • Weber MA, Bakris GL, Jamerson K, Weir M, Kjeldsen SE, Devereux RB, Velazquez EJ, Dahlof B, Kelly RY, Hua TA, Hester A, Pitt B; ACCOMPLISH Investigators. Cardiovascular events during differing hypertension therapies in patients with diabetes. J Am Coll Cardiol. 2010 Jun 29;56(1):77-85. doi: 10.1016/j.jacc.2010.02.046.

    PubMed 20620720
  • Bakris GL, Sarafidis PA, Weir MR, Dahlof B, Pitt B, Jamerson K, Velazquez EJ, Staikos-Byrne L, Kelly RY, Shi V, Chiang YT, Weber MA; ACCOMPLISH Trial investigators. Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial. Lancet. 2010 Apr 3;375(9721):1173-81. doi: 10.1016/S0140-6736(09)62100-0. Epub 2010 Feb 18.

    PubMed 20170948

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Benazepril/amlodipine 20/5 mg - Dose Level 1 from Day 1 to Month 1, Benazepril/amlodipine 40/5 mg - Dose Level 2 from Month 1 to Month 2 and Benazepril/amlodipine 40/10 mg - Dose Level 3 from Month 2 to Month 3 and thereafter in people with Hypertension, run by Novartis at 5 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 24 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in United States, Denmark, Finland, Norway, Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 17 May 2011). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time-to-event Analysis of Percentage of Patients With a Composite Cardiovascular (CV) Morbidity or Mortality Event (time frame: For each patient, baseline to time of first CV morbidity or mortality event (or last exposure if no event occurred). (Median duration of exposure was 33.4 months. [25th to 75th percentiles: 21 to 41 months.])). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00170950, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Oct 2023.

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