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Blood Pressure, HighPhase 4REALITYNCT01060865

Evaluation of Aliskiren Efficacy by Different Methods of Blood Pressure Measurements

A Phase 4 study testing Aliskiren in people with Blood Pressure, High, run by Meir Medical Center at 1 site in Israel.

Terminated

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

Official record
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Trial summary

Almost 50% of hypertensive patients remain uncontrolled. Clinical decisions are mostly based on office blood pressure,despite the fallacies of this method of measurement. Other reasons for not achieving blood pressure targets are lack of 24-hr efficacy and tolerability of existing anti-hypertensive drug classes. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Blood Pressure, High
What is being tested?
Aliskiren
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteIsrael
Study dates
Mar 2010to Dec 2011
Phase
Phase 4
Are there results?
None posted in the registry

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 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Essential hypertension at visit 1 defined as office blood pressure <140/90 mmHg and a 24 h ABPM >130/80 mmHg with a day time BP (extracted from the 24h ABPM) >135/85 mmHg
  • Male and female
  • Age 18-80
  • Every patient that in the medical opinion of the treating physician is eligible for Rasilez treatment
  • Willing to sign an informed consent

Who cannot join

  • Use of more then 1 anti hypertensive medication at visit 1 (fixed combination is considered as two drugs)
  • Use of ACEI or ARB at base line visit
  • Pregnant women
  • WOCB - (will follow the usual limitations)
  • Use of certain medications (e.g. Cyclosporine, Verapamil, Quinidine)
  • Uncontrolled DM (investigator decision)
Show all 11Show fewer
  • Any of the following in the last six months: MI, Stroke, CABG, PTCI
  • Congestive HF requiring pharmacological treatment
  • Renal Failure, defined as serum creatinine equal or great than 1.5 mg% [confirmed twice] or hyperkalemia defined as serum potassium equal or great that 5 meq/l [confirmed twice]
  • Malignancy that required Chemotherapy in the last 3 years
  • Any medical or none medical condition that in the eyes of the investigator will not allow the patient to complete the study

Trial locations and contacts

1 site in 1 country.

Israel1 site
  • Clalit health services

    Herzliya, Hasharon Area

Other trials in Israel

About this study

Official title: Treatment of Essential Hypertension With Rasilez. Evaluation of Different Methods of Blood Pressure Measurements - Efficacy and Safety Evaluation

Almost 50% of hypertensive patients remain uncontrolled. Clinical decisions are mostly based on office blood pressure,despite the fallacies of this method of measurement. Other reasons for not achieving blood pressure targets are lack of 24-hr efficacy and tolerability of existing anti-hypertensive drug classes. Aliskiren (Rasilez®) is a new antihypertensive drug, given once a day.

The purpose of the REALITY study-[tREAtment of essentiaL hypertension with rasIlez. evaluation of different methods of blood pressure measurements - efficacy and safeTY evaluation -] is to evaluate the efficacy, and tolerability of aliskiren in a "real life" setting. The efficacy of the drug will be evaluated using 24 hour ambulatory blood pressure monitoring (ABPM). Results will be compared with office, nurse or self blood pressure monitoring. This comparison will allow to decide which follow-up technique is better for those hypertensive patients.

Read the detailed description

This is a single centre observational uncontrolled prospective study, Hypertensive patients that are either treatment naïve or uncontrolled on current monotherapy and meet all inclusion and exclusion criteria, will be assigned to Rasilez treatment (start for 2 weeks on 150 mg and if well tolerated the dosage will be increased to 300 mg). The treatment will then be continued for additional 10 weeks. Rasilez can be administrated as monotherapy or as add on to other antihypertensive (patients currently on single medication).

The patient will have additional visits at week 6, and at week 12 For all eligible patients a 24 h ABPM test will be performed at the week prior to visit 2 (treatment initiation) and at the week prior to the final visit.

Each patient will receive an automatic blood pressure monitor [OMRON MX3 plus] for SBPM measurements, The monitor will be provided by the sponsor for the whole study period. The patient will be trained for blood pressure measurements. SBPM will be performed twice a week [morning and evening] Nurse blood pressure measurements will be performed at each visit, after 10 minutes of rest, prior to the medical visit.

Office blood pressure will be performed by the physician at each visit Blood samples for electrolytes, renal function, liver function and hematology, will be taken at base line visit, at week 2 and at week 12 Other antihypertensive can be added at any time during the study, according to the decision of the investigator, except ACE inhibitors and ARBs.

AEs have to be reported at the appropriate site on the CRF page. In case of discontinuation of aliskiren or interruption of aliskiren treatment the reason has to be given. Serious adverse events (SAEs) have to be documented additionally on the separate SAE form and have to be reported within 24h to the NOVARTIS Pharma, Drug safety department Adherence to treatment will be evaluated using standard formulas. Estimated time for recruitment of 50 patients: One year. Study design scheme Visit 1 -[week -2] physician and nurse BP. Sign inform consent- command ABPM a week prior to visit 2 - SBPM training Visit 2 [week 0] physician and nurse BP. Start Rasilez 150 mg and command laboratory exams prior to next visit.

Visit 3 [week 2] physician and nurse BP. Titrate Rasilez to 300 mg Visit 4 (week 6). physician and nurse BP. ABPM and command lab exams (a week prior to visit 5) Visit 5 (12 weeks) physician and nurse BP SBPM data will be collected at visit 2,3,4 and 5.

Efficacy will be defined in terms of therapeutic goals expressed as target blood pressures according to WHO and ESH [ for SBPM and ABPM] criteria:

Office Blood Pressure: Diastolic blood pressure (DBP) ≤ 90 mmHg and Systolic blood pressure (SBP) ≤ 140 mmHg for non-diabetics or DBP≤ 80 mmHg and SBP≤ 130 mmHg for diabetics, respectively.

SBPM : DBP ≤ 85 mmHg and SBP ≤ 135 mmHg 24 h ABPM: DBP≤ 130/80 mmHg SBP≤ 130 mmHg, Awake DBP ≤ 85 mmHg, Awake SBP ≤ 135 mmHg Asleep DBP ≤70 mmHg, asleep SBP ≤ 70 mmHg. Effectiveness and Safety will also be evaluated taking into consideration patient compliance

Safety assessments:

Safety will be assessed by means of (S)AE reporting.

Being tested
Aliskiren
Keywords
hypertension, aliskiren, Blood Pressure Monitoring, Ambulatory
Medical subject headings
Hypertension

What participants receive

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

  • AliskirenDrug

    Also called Blood Pressure, Ambulatory Blood Pressure monitor, Self measured home blood pressure

    150 mg during the first two weeks , 300 mg for another 10 weeks

Study groups in NCT01060865
Study groupRoleWhat they receive
AliskirenExperimentalonly one arm with the experimental drug [aliskiren]
Receives: Drug: Aliskiren

What is being measured

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

  1. Percentage of patients with controlled blood pressure with office BP measurements, nurse measurements and SBPM, from baseline to week 12, compared and ABPM.

    Measured: 12 weeks

Secondary outcomes (4)
  1. Compare the SBP/DBP lowering efficacy of Rasilez treatment in patients with essential hypertension as measured by 4 different methods - 24h Ambulatory BP measurement, Office BP, Home BP and Nurse BP measurement.

    Measured: 12 weeks

  2. To assess patient adherence to treatment.

    Measured: 2, 6 and 12 weeks

  3. To evaluate the safety profile of Rasilez treatment in patients with essential hypertension.

    Measured: 2, 6 and 12 weeks

  4. Evaluate the antihypertensive effect of Rasilez in "real life", based on the 24h ABPM changes from base line to week 12.

    Measured: 12 weeks

Timeline

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

  1. First posted2 Feb 2010 (estimated)
  2. Study startMar 2010
  3. Primary completionOct 2011
  4. Study completionDec 2011

Why it stopped: The participants signed an old version of the informed consent.

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 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01060865
Sponsor's protocol ID
CSPP100AIL02T
Acronym
REALITY
Status last verified
May 2011
First submitted
1 Feb 2010
Last updated
11 Jan 2017
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Undecided

Publications

  • Schmieder RE, Philipp T, Guerediaga J, Gorostidi M, Bush C, Keefe DL. Aliskiren-based therapy lowers blood pressure more effectively than hydrochlorothiazide-based therapy in obese patients with hypertension: sub-analysis of a 52-week, randomized, double-blind trial. J Hypertens. 2009 Jul;27(7):1493-501. doi: 10.1097/HJH.0b013e32832be593.

    PubMed 19444142
  • Gradman AH, Schmieder RE, Lins RL, Nussberger J, Chiang Y, Bedigian MP. Aliskiren, a novel orally effective renin inhibitor, provides dose-dependent antihypertensive efficacy and placebo-like tolerability in hypertensive patients. Circulation. 2005 Mar 1;111(8):1012-8. doi: 10.1161/01.CIR.0000156466.02908.ED. Epub 2005 Feb 21.

    PubMed 15723979
  • Uresin Y, Taylor AA, Kilo C, Tschope D, Santonastaso M, Ibram G, Fang H, Satlin A. Efficacy and safety of the direct renin inhibitor aliskiren and ramipril alone or in combination in patients with diabetes and hypertension. J Renin Angiotensin Aldosterone Syst. 2007 Dec;8(4):190-8. doi: 10.3317/jraas.2007.028.

    PubMed 18205098
  • Verdecchia P, Calvo C, Mockel V, Keeling L, Satlin A. Safety and efficacy of the oral direct renin inhibitor aliskiren in elderly patients with hypertension. Blood Press. 2007;16(6):381-91. doi: 10.1080/08037050701717014.

    PubMed 18058456
  • Jordan J, Engeli S, Boye SW, Le Breton S, Keefe DL. Direct Renin inhibition with aliskiren in obese patients with arterial hypertension. Hypertension. 2007 May;49(5):1047-55. doi: 10.1161/HYPERTENSIONAHA.106.084301. Epub 2007 Mar 12.

    PubMed 17353513
  • Burt VL, Cutler JA, Higgins M, Horan MJ, Labarthe D, Whelton P, Brown C, Roccella EJ. Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. Hypertension. 1995 Jul;26(1):60-9. doi: 10.1161/01.hyp.26.1.60.

    PubMed 7607734
  • Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, Jones DW, Kurtz T, Sheps SG, Roccella EJ; Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension. 2005 Jan;45(1):142-61. doi: 10.1161/01.HYP.0000150859.47929.8e. Epub 2004 Dec 20.

    PubMed 15611362
  • Dolan E, Stanton AV, Thom S, Caulfield M, Atkins N, McInnes G, Collier D, Dicker P, O'Brien E; ASCOT Investigators. Ambulatory blood pressure monitoring predicts cardiovascular events in treated hypertensive patients--an Anglo-Scandinavian cardiac outcomes trial substudy. J Hypertens. 2009 Apr;27(4):876-85. doi: 10.1097/HJH.0b013e328322cd62.

    PubMed 19516185

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Aliskiren in people with Blood Pressure, High, run by Meir Medical Center at 1 site in Israel.

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 5 inclusion and 11 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 11 Jan 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Israel. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

The study was stopped early (reason given: The participants signed an old version of the informed consent.). Results are not available in the source record.

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?

Percentage of patients with controlled blood pressure with office BP measurements, nurse measurements and SBPM, from baseline to week 12, compared and ABPM. (time frame: 12 weeks). 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 NCT01060865, which also lists 8 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 11 Jan 2017.

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