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HypertensionPhase 4ALLMARKNCT01176032

ALiskiren or Losartan Effects on bioMARKers of Myocardial Remodeling

A Phase 4 study testing Aliskiren, Losartan and Amlodipine in people with Hypertension and Left Ventricle Hypertrophy, run by Novartis Pharmaceuticals at 25 sites in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to assess efficacy of aliskiren for reducing circulating levels of biomarkers of left ventricular (LV) remodeling associated with LV hypertrophy (LVH) in hypertensive patients. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Hypertension, Left Ventricle Hypertrophy
What is being tested?
Aliskiren, Losartan and Amlodipine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
74 participants
Where
25 sitesSpain
Study dates
Jun 2010to Apr 2013
Phase
Phase 4
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 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient with hypertension
  • Confirmed concentric left ventricular hypertrophy:
  • LVMI > 49.2 g/m2.7 for men and >46.7 g/m2.7 for women
  • Relative wall thickness > 0.42

Who cannot join

  • Sever or secondary HTN
  • LV ejection fraction of <40%
  • Patient with compelling indication to ACEIs or ARBs or BB
  • History of myocardial infarction, coronary artery bypass surgery, PTC intervention, TIA or stroke within 6 months of study entry
  • History of collagenopathies, osteopathy
  • eGFR <30 ml/min/1,73 m2, serum potassium ≥5,2 mEq/L
  • Morbid obesity (BMI ≥ 42 kg/m2
  • Other protocol-defined inclusion/exclusion criteria may apply

Trial locations and contacts

25 sites in 1 country.

25 sites in 1 country

Spain25 sites
  • Novartis Investigative Site

    Alicante, Valencia, 03004

  • Novartis Investigative Site

    Barcelona, Barcelona, 08025

  • Novartis Investigative Site

    Barcelona, Catalonia, 08036

  • Novartis Investigative Site

    Barcelona, 08006

  • Novartis Investigative Site

    Bilbao, Basque Country, 48013

  • Novartis Investigative Site

    Burgos, Castille and León, 09005

  • Novartis Investigative Site

    Galdakano, Basque Country, 48960

  • Novartis Investigative Site

    Girona, Catalonia, 17007

  • Novartis Investigative Site

    L'Hospitalet de Llobregat, Catalonia, 08907

  • Novartis Investigative Site

    Madrid, Madrid, 28009

  • Novartis Investigative Site

    Madrid, Madrid, 28035

  • Novartis Investigative Site

    Madrid, Madrid, 28040

  • Novartis Investigative Site

    Madrid, Madrid, 28041

  • Novartis Investigative Site

    Madrid, Madrid, 28046

  • Novartis Investigative Site

    Sanlúcar de Barrameda, Andalusia, 11540

  • Novartis Investigative Site

    Santa Coloma de Gramanet, Catalonia

  • Novartis Investigative Site

    Santander, 39008

  • Novartis Investigative Site

    Santiago de Compostela, Galicia, 15706

  • Novartis Investigative Site

    Seville, Andalusia, 41009

  • Novartis Investigative Site

    Seville, Andalusia, 41013

  • Novartis Investigative Site

    Torrevieja (Alicante), Valencia, 03186

  • Novartis Investigative Site

    Utrera, Andalusia, 41710

  • Novartis Investigative Site

    Valencia, Valencia, 46010

  • Novartis Investigative Site

    Valencia, Valencia, 46014

  • Novartis Investigative Site

    Vitoria-Gasteiz, Basque Country

Other trials in Spain

About this study

Official title: The "ALiskiren or Losartan Effects on bioMARKers of Myocardial Remodeling (ALLMARK)" Study

The purpose of this study is to assess efficacy of aliskiren for reducing circulating levels of biomarkers of left ventricular (LV) remodeling associated with LV hypertrophy (LVH) in hypertensive patients.

Read the detailed description

Blood pressure was measured 10 weeks after starting treatment (visit 3). All patients who did not achieve the required blood pressure (<140/90 mmHg) after 8 weeks of treatment at the maximum doses of study medication were given 5 mg of amlodipine in addition to the study medication in order to reach the required BP (<140/90 mmHg).

The patient's blood pressure was assessed at visit 4 (week 18) and if it was still not at the required level (<140/90 mmHg), the dose of amlodipine was increased to 10 mg.

Blood pressure was again assessed at visit 5 (week 26) and if the required values had not been reached (<140/90 mmHg), a 12.5 mg dose of hydrochlorothiazide (HCTZ) was prescribed

Being tested
Aliskiren, Losartan, Amlodipine, Hydrochlorothiazide (HCTZ)
Keywords
Aliskiren, hypertension, concentric LVH, LV remodeling, LVMI, biomarkers, PICP, CT-1, MMP-1, TIMP-1, AnxA5, Aldosterone, Essential hypertension with concentric left ventricle hypertrophy
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 Rasilez

    Aliskiren 300 mg film coated tablets

  • LosartanDrug

    Losartan 100 mg tablets

  • AmlodipineDrug

    Amlodipine 5mg was given to patients who did not achieve the required blood pressure (<140/90 mmHg) after 8 weeks (visit 3)of treatment at the maximum doses of study medication in addition to the study medication in order to reach the required BP. at visit 4 (week 18) the dose of amlodipine was increased to 10mg if the required level (<140/90 mmHg) was still not achieved.

  • Hydrochlorothiazide (HCTZ)Drug

    HCTZ 12.5mg was prescribed at visit 5 (week 26) if the required values (<140/90 mmHg) had not been reached.

Study groups in NCT01176032
Study groupRoleWhat they receive
AliskirenExperimentalAliskiren 150 mg od for 2 weeks and up-titration to aliskiren 300 mg od for 34 weeks. In addition to the study medication, amlodipine 5mg was given to patients who did not achieve the required blood pressure (<140/90 mmHg) after 8 weeks of treatment at the maximum doses of study medication. At week 18 the dose of amlodipine was increased to 10mg if the required level (<140/90 mmHg) was still not achieved. HCTZ 12.5mg was prescribed at week 26 if the required values (<140/90 mmHg) had not been reached.
Receives: Drug: Aliskiren; Drug: Amlodipine; Drug: Hydrochlorothiazide (HCTZ)
LostaranActive comparatorLosartan 50 mg od for 2 weeks and up-titration to losartan 100 mg od for 34 weeks. In addition to the study medication, amlodipine 5mg was given to patients who did not achieve the required blood pressure (<140/90 mmHg) after 8 weeks of treatment at the maximum doses of study medication. At week 18 the dose of amlodipine was increased to 10mg if the required level (<140/90 mmHg) was still not achieved. HCTZ 12.5mg was prescribed at week 26 if the required values (<140/90 mmHg) had not been reached.
Receives: Drug: Losartan; Drug: Amlodipine; Drug: Hydrochlorothiazide (HCTZ)

What is being measured

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

  1. Change From Baseline in C-terminal Propeptide of Procollagen Type I (PICP)

    PICP is a measure of blood concentration of procollagen I carboxy-terminal propeptide (PICP), a peptide released from the myocardium when procollagen is converted to type I collagen. This biomarker exhibits good specificity and sensitivity for identifying myocardial fibrosis in hypertension.

    Measured: Baseline, Week 36

Secondary outcomes (19)
  1. Change From Baseline in Biomarkers in Heart Disease

    The plasma level of biomarkers parameters used to measure improvement in left ventricular (LV) function or reduction in left ventricular mass index (LVMI). The following biomarkers were analyzed: cardiotrophin-1 (CT-1), matrix metalloproteinase-1 (MMP-1); tissue inhibitor of MMPs (TIMP-1); annexin A5 (AnxA5); N-terminal prohormone of B-type natriuretic peptide (NT-proBNP)

    Measured: Baseline, Week 36

  2. Change From Baseline in Biomarker Such as Aldosterone (Aldo) in Heart Disease

    The plasma level of biomarker parameter (aldosterone (Aldo)) used to measure improvement in left ventricular (LV) function or reduction in left ventricular mass index (LVMI)

    Measured: Baseline, Week 36

  3. Change From Baseline in Left Ventricular (LV) Function, LV End-diastolic Volume by Simpson's Rule, and LV End-systolic Volume by Simpson's Rule

    Reductions in the following measurements were analysed between the baseline visit and the final visit: LV end-diastolic volume by Simpson's rule, and LV end-systolic volume by Simpson's rule

    Measured: Baseline, Week 36

  4. Change From Baseline in Left Ventricular (LV) Function, LV Ejection Fraction (Teicholz), and LV Ejection Fraction (Simpson)

    Reductions in the following measurements were analysed between the baseline visit and the final visit: LV ejection fraction (Teicholz), and LV ejection fraction (Simpson)

    Measured: Baseline, Week 36

  5. Change From Baseline in Left Ventricular (LV) Function, LA (Left Atrium) Diameter

    Reductions in the following measurements were analysed between the baseline visit and the final visit: LA diameter

    Measured: Baseline, Week 36

  6. Change From Baseline in Left Ventricular (LV) Function, Left Atrial Volume (Biplane Simpson's Method)

    Reductions in the following measurements were analysed between the baseline visit and the final visit: left atrial volume (biplane Simpson's method)

    Measured: Baseline, Week 36

  7. Change From Baseline in Reduction of Left Ventricular Mass Index (LVMI)

    Echocardiogram was performed at week 1 and at week 36. Reduction in LVMI is defined as the difference between the LVMI at the final visit and the baseline LVMI

    Measured: Baseline, Week 36

  8. Change From Baseline in Combination of Aliskiren With Amlodipine in Biomarkers of Heart Disease.

    The plasma level of biomarkers parameters used to measure improvement in left ventricular (LV) function or reduction in left ventricular mass index (LVMI). The following biomarkers were analyzed: cardiotrophin-1 (CT-1), matrix metalloproteinase-1 (MMP-1); tissue inhibitor of MMPs (TIMP-1); annexin A5 (AnxA5); N-terminal prohormone of B-type natriuretic peptide (NT-proBNP)

    Measured: Baseline, Week 36

  9. Change From Baseline in Biomarker Such as Aldosterone (Aldo) in Heart Disease in Combination of Aliskiren With Amlodipine

    The plasma level of biomarker parameter plasma aldosterone used to measure improvement in left ventricular (LV) function or reduction in left ventricular mass index (LVMI).

    Measured: Baseline, Week 36

  10. Change From Baseline in Left Ventricular (LV) Function, LV End-diastolic Volume by Simpson's Rule, and LV End-systolic Volume by Simpson's Rule in Combination of Aliskiren With Amlodipine

    Reductions in the following measurements were analysed between the baseline visit and the final visit: LV end-diastolic volume by Simpson's rule, and LV end-systolic volume by Simpson's rule

    Measured: Baseline, Week 36

  11. Change From Baseline in Left Ventricular (LV) Function, LV Ejection Fraction (Teicholz), and LV Ejection Fraction (Simpson) in Combination of Aliskiren With Amlodipine

    Reductions in the following measurements were analysed between the baseline visit and the final visit: LV ejection fraction (Teicholz), and LV ejection fraction (Simpson)

    Measured: Baseline, Week 36

  12. Change From Baseline in Left Ventricular (LV) Function, LA (Left Atrium) Diameter in Combination of Aliskiren With Amlodipine

    Reductions in the following measurements were analysed between the baseline visit and the final visit: LA diameter

    Measured: Baseline, Week 36

  13. Change From Baseline in Left Ventricular (LV) Function, Left Atrial Volume (Biplane Simpson's Method) in Combination of Aliskiren With Amlodipine

    Reductions in the following measurements were analysed between the baseline visit and the final visit: left atrial volume (biplane Simpson's method)

    Measured: Baseline, Week 36

  14. Change From Baseline of LVMI in Combination of Aliskiren With Amlodipine

    Echocardiogram was performed at week 1 and at week 36. Reduction in LVMI is defined as the difference between the LVMI at the final visit and the baseline LVMI

    Measured: Baseline, Week 36

  15. Effectivness of Aliskiren in Controlling Blood Pressure Compare to Losartan in Terms of Reduction in Systolic Blood Pressure (SBP)

    The mean systolic BP (SBP) and diastolic BP (DBP) readings for the aliskiren and losartan treatment groups, the difference in these values between the two groups and the comparison of post-baseline vs. baseline values

    Measured: Baseline, Week 10,18,26,36

  16. Effectivness of Aliskiren in Controlling Blood Pressure Compare to Losartan in Terms of Reduction in Diastolic Blood Pressure (DBP)

    The mean systolic BP (SBP) and diastolic BP (DBP) readings for the aliskiren and losartan treatment groups, the difference in these values between the two groups and the comparison of post-baseline vs. baseline values

    Measured: Baseline, Week 10,18,26,36

  17. Effectivness of Aliskiren in Controlling Blood Pressure Compare to Losartan in Terms of Patients With Satisfactory Response Rate

    Response rate was defined as the proportion of patients with a satisfactory systolic BP response (SBP < 140 mmHg or reduction of ≥ 10 mmHg compared to baseline) and a satisfactory diastolic BP response (DBP < 90 mmHg or reduction of ≥ 5 mmHg compared to baseline)

    Measured: Baseline, Week10,18,26,36

  18. Effectivness of Aliskiren in Controlling Blood Pressure Compare to Losartan in Terms of Patients With SBP < 140 mmHg and DBP < 90 mmHg Compared to Baseline

    The control rate was defined as the proportion of patients with SBP < 140 mmHg and DBP < 90 mmHg compared to baseline

    Measured: Week10,18,26,36

  19. Effectivness of Aliskiren in Controlling Blood Pressure Compare to Losartan in Terms of Rate of Use of Added Antihypertensive Rescue Drugs

    The rate of use of first and second antihypertensive rescue drugs added was also assessed at all visits after week 2. The rescue drug at week 10 and 18 for those patients not achieving the required BP was amlodipine, Patients who did not achieve the required BP at week 26 were treated with hydrochlorothiazide

    Measured: Baseline, Week 10,18,26

Timeline

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

  1. First posted5 Aug 2010 (estimated)
  2. Study startJun 2010
  3. Primary completionApr 2013
  4. Study completionApr 2013

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
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
74 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01176032
Sponsor's protocol ID
CSPP100AES02
Other IDs
2009-016735-36, 2009
Acronym
ALLMARK
Status last verified
Jul 2014
First submitted
2 Aug 2010
Last updated
24 Jul 2014

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Aliskiren, Losartan and Amlodipine in people with Hypertension and Left Ventricle Hypertrophy, run by Novartis Pharmaceuticals at 25 sites in Spain.

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 4 inclusion and 8 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: finished, as of the sponsor's last update on 24 Jul 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 25 sites in Spain. 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?

Yes. Results are posted in the registry (first posted 24 Jul 2014). 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?

Change From Baseline in C-terminal Propeptide of Procollagen Type I (PICP) (time frame: Baseline, Week 36). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 Jul 2014.

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