HypertensionPhase 4NCT01275352
CLCNKA (Ka Renal Chloride Channel[ClC-Ka]) Polymorphism Effects on Hypertrophy Regression
A Phase 4 study testing Eplerenone in people with Hypertension, run by Washington University School of Medicine at 2 sites in United States.
Trial summary
This study will consist of middle-aged Caucasian non-failing subjects with high blood pressure who are homozygous for a gene that confers increased risk of developing heart failure, the Glycine 83 variant of the Ka renal chloride channel (ClC-Ka Gly/Gly 83), or middle-aged Caucasian non-failing hypertensive subjects… Read more about this study
- Who is it for?
- Ages 40 to 80 years
- Conditions the study is for
- Hypertension
- What is being tested?
- Eplerenone
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 0 participants
- Where
- 2 sitesUnited States
- Study dates
- Dec 2011to Jun 2015
- 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 40 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Caucasians with hypertension who are homozygous for the ClC-Ka Gly/Gly83 and the ClC-Ka Arg/Arg 83 allele.
- Male or non-pregnant female aged 40 to 80 years.
- Hypertension, defined as currently taking high blood pressure medications or not on medications but having SDP >140 or DBP >90.
- Ejection fraction > 50% by any method within 6 months of the screening visit.
- The Investigator must obtain written informed consent before the subject is screened for the study.
- Subject should be on stable dose of ACE or ARB at moderate dosing for at least 4 weeks before randomization.
Who cannot join
- History of heart failure with preserved or depressed ejection fraction.
- Creatinine clearance of < 45 mL/min based on the Cockcroft-Gault formula (Appendix C).
- Pregnancy
- Life expectancy less than 12 months.
- Planned cardiac surgery or percutaneous cardiac intervention within 3 months.
- Serum potassium >5.5 mEq/L.
Show all 15Show fewer
- History of hyperkalemia (K>6.0 mEq/L) with eplerenone or spironolactone.
- Myocardial infarction or stroke within 3 months of screening.
- Evidence of clinical instability (hypotension, arrhythmias, unstable angina etc.).
- Subjects on or requiring K-sparing diuretics or spironolactone.
- Concomitant use of potent inhibitors of CYP3A4 including ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, and nelfinavir or any drug noted in the Contraindications, Warnings or Precautions sections of their labeling to be potent CYP3A4 inhibitors
- Known hypersensitivity to eplerenone or spironolactone.
- Evidence of current alcohol or drug abuse Severe organic disorders or surgery or disease of the gastrointestinal tract that in the opinion of the Investigator may interfere in the absorption and elimination of the study drug.
- Psychoses or behavioral conditions that in the opinion of the Investigator would limit study compliance.
- Subjects who have received any investigational medication or used any investigational device within 30 days prior to first dose of study drug or subjects actively participating in any investigational drug or device study.
Trial locations and contacts
2 sites in 1 country.
United States2 sites
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, 19104
Barnes Jewish Hospital
St Louis, Missouri, 63108
About this study
Official title: A Randomized, Double Blind Pilot Study Evaluating CLCNKA (Ka Renal Chloride Channel[ClC-Ka]) Polymorphism Effects on Hypertrophy Regression in Caucasian Hypertensive Patients Treated With Eplerenone
This study will consist of middle-aged Caucasian non-failing subjects with high blood pressure who are homozygous for a gene that confers increased risk of developing heart failure, the Glycine 83 variant of the Ka renal chloride channel (ClC-Ka Gly/Gly 83), or middle-aged Caucasian non-failing hypertensive subjects who lack the heart failure risk gene, the wild-type Arginine 83 Ka renal chloride channel (ClC-Ka Arg/Arg 83). Subjects on standard therapy for high blood pressure with an angiotensin converting inhibitor (ACEI) or angiotensin receptor blocker (ARB) will be randomized to additional treatment with eplerenone (an aldosterone antagonist) or placebo, and assessed for changes in echocardiographic left ventricular hypertrophy (LVMI). Secondary endpoints will assess left ventricular remodeling and other echocardiographic variables. The investigators hypothesize that subjects homozygous for the CLCNKA risk allele will have a greater response to eplerenone in terms of reductions in LVMI than those lacking the risk allele.
Read the detailed description
The screening phase will involve identifying Caucasian hypertensive patients who are homozygous for the ClC-Ka Gly/Gly83 and the ClC-Ka Arg/Arg 83 allele. All patients will be on background therapy with an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) at least mid range dosing. If patient is not at recommended dose of ACE or ARB they must be titrated up and be stable on a midrange dose of ACEI or ARB for at least 4 weeks before they can be entered into the study. There will be 2 treatment phases. Phase 1 will be up to 4 weeks in duration and will consist of randomization to one table of eplerenone (25 mg) or matching placebo. On week 2 the patient will be up titrated to two tablets of eplerenone (50 mg) or matching placebo, to achieve a target dose of 50 mg of eplerenone. If the patient cannot tolerate two tablets of eplerenone or matching placebo they can be down titrated to one tablet of eplerenone or matching placebo. The target BP on study medication is < 130/80 mmHg. After the patients have been up titrated to the maximally tolerated dose of study medication, the background hypertension therapy can be adjusted to reach the target BP of < 130/80 mmHg by the end of week 4. Phase 2 will be 52 weeks in duration to assess the effects of placebo or eplerenone on LV hypertrophy. Serum potassium will be monitored throughout the study, and if necessary, doses of eplerenone will be titrated down as necessary.
- Conditions
- Hypertension
- Being tested
- Eplerenone, placebo
- Keywords
- left ventricular hypertrophy, heart failure
- Medical subject headings
- Hypertension, Hypertrophy, Left Ventricular, Heart Failure
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
EplerenoneDrug
Also called Inspra, aldosterone antagonist
Eplerenone 50 mg/day
placeboDrug
placebo
| Study group | Role | What they receive |
|---|---|---|
| Arm 1 | Active comparator | Caucasian hypertensive patients who are homozygous for the ClC-Ka Gly/Gly83 allele Receives: Drug: Eplerenone |
| Arm 2 | Active comparator | Caucasian hypertensive patients who are homozygous for ClC-Ka Arg/Arg 83 allele Receives: Drug: Eplerenone |
| Arm 3 | Placebo comparator | Caucasian hypertensive patients who are homozygous for ClC-Ka Arg/Arg 83 allele Receives: Drug: placebo |
| Arm 4 | Placebo comparator | Caucasian hypertensive patients who are homozygous for the ClC-Ka Gly/Gly83 allele Receives: Drug: placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in LV mass index (g/m2) in ClC-Ka Gly/Gly83 patients and ClC-Ka Gly/Gly83 patients
Measured: 12 months
Secondary outcomes (3)
Change in LV relative wall thickness
Measured: 6 and 12 months
Change in N-terminal pro-brain natriuretic peptide (NT-proBNP)
Measured: 6 and 12 months
Change in LV mass index (g/m2)
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jan 2011 (estimated)
- Study startDec 2011
- Primary completionDec 2014 (estimated)
- Study completionJun 2015
Why it stopped: Lack of funding
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for HypertensionStudies of the same condition, open and under way.
- More trials run by Washington University School of MedicineThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Factorial
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- Washington University School of Medicine
- Sponsor type
- University, hospital or other
- Collaborators
- University of Pennsylvania
- Investigators
- Thomas Cappola, MD, Principal investigator, University of PennsylvaniaGerald Dorn, MD, Principal investigator, Washington University School of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01275352
- Sponsor's protocol ID
- CLNCKA-1
- Status last verified
- Jun 2015
- First submitted
- 10 Jan 2011
- Last updated
- 3 Jun 2015
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 3 Jun 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double Blind Pilot Study Evaluating CLCNKA (Ka Renal Chloride Channel[ClC-Ka]) Polymorphism Effects on Hypertrophy Regression in Caucasian Hypertensive Patients Treated With Eplerenone
- ClinicalTrials.gov ID
- NCT01275352
- Acronym / sponsor ID
- CLNCKA-1
- Conditions
- Hypertension
- Keywords
- left ventricular hypertrophy, heart failure
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- WithdrawnReason stopped: Lack of funding
- Enrolment
- 0 participants (actual)
- Lead sponsor
- Washington University School of MedicineUniversity, hospital or other
- Collaborators
- University of Pennsylvania
- Study start
- Dec 2011
- Primary completion
- Dec 2014 (estimated)
- Study completion
- Jun 2015 (actual)
- First posted
- 12 Jan 2011 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will consist of middle-aged Caucasian non-failing subjects with high blood pressure who are homozygous for a gene that confers increased risk of developing heart failure, the Glycine 83 variant of the Ka renal chloride channel (ClC-Ka Gly/Gly 83), or middle-aged Caucasian non-failing hypertensive subjects who lack the heart failure risk gene, the wild-type Arginine 83 Ka renal chloride channel (ClC-Ka Arg/Arg 83). Subjects on standard therapy for high blood pressure with an angiotensin converting inhibitor (ACEI) or angiotensin receptor blocker (ARB) will be randomized to additional treatment with eplerenone (an aldosterone antagonist) or placebo, and assessed for changes in echocardiographic left ventricular hypertrophy (LVMI). Secondary endpoints will assess left ventricular remodeling and other echocardiographic variables. The investigators hypothesize that subjects homozygous for the CLCNKA risk allele will have a greater response to eplerenone in terms of reductions in LVMI than those lacking the risk allele.
Detailed description
The screening phase will involve identifying Caucasian hypertensive patients who are homozygous for the ClC-Ka Gly/Gly83 and the ClC-Ka Arg/Arg 83 allele. All patients will be on background therapy with an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) at least mid range dosing. If patient is not at recommended dose of ACE or ARB they must be titrated up and be stable on a midrange dose of ACEI or ARB for at least 4 weeks before they can be entered into the study. There will be 2 treatment phases. Phase 1 will be up to 4 weeks in duration and will consist of randomization to one table of eplerenone (25 mg) or matching placebo. On week 2 the patient will be up titrated to two tablets of eplerenone (50 mg) or matching placebo, to achieve a target dose of 50 mg of eplerenone. If the patient cannot tolerate two tablets of eplerenone or matching placebo they can be down titrated to one tablet of eplerenone or matching placebo. The target BP on study medication is < 130/80 mmHg. After the patients have been up titrated to the maximally tolerated dose of study medication, the background hypertension therapy can be adjusted to reach the target BP of < 130/80 mmHg by the end of week 4. Phase 2 will be 52 weeks in duration to assess the effects of placebo or eplerenone on LV hypertrophy. Serum potassium will be monitored throughout the study, and if necessary, doses of eplerenone will be titrated down as necessary.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Arm 1 | Active comparator | Drug: EplerenoneCaucasian hypertensive patients who are homozygous for the ClC-Ka Gly/Gly83 allele |
| Arm 2 | Active comparator | Drug: EplerenoneCaucasian hypertensive patients who are homozygous for ClC-Ka Arg/Arg 83 allele |
| Arm 3 | Placebo comparator | Drug: placeboCaucasian hypertensive patients who are homozygous for ClC-Ka Arg/Arg 83 allele |
| Arm 4 | Placebo comparator | Drug: placeboCaucasian hypertensive patients who are homozygous for the ClC-Ka Gly/Gly83 allele |
Who may qualify
- Ages
- 40 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Caucasians with hypertension who are homozygous for the ClC-Ka Gly/Gly83 and the ClC-Ka Arg/Arg 83 allele.
- Male or non-pregnant female aged 40 to 80 years.
- Hypertension, defined as currently taking high blood pressure medications or not on medications but having SDP >140 or DBP >90.
- Ejection fraction > 50% by any method within 6 months of the screening visit.
- The Investigator must obtain written informed consent before the subject is screened for the study.
Key exclusion criteria (15 listed)
- History of heart failure with preserved or depressed ejection fraction.
- Creatinine clearance of < 45 mL/min based on the Cockcroft-Gault formula (Appendix C).
- Pregnancy
- Life expectancy less than 12 months.
- Planned cardiac surgery or percutaneous cardiac intervention within 3 months.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| EplerenoneAlso: Inspra, aldosterone antagonistEplerenone 50 mg/day | Drug | Arm 1, Arm 2 |
| placeboplacebo | Drug | Arm 3, Arm 4 |
Primary outcome
Change in LV mass index (g/m2) in ClC-Ka Gly/Gly83 patients and ClC-Ka Gly/Gly83 patients
Time frame: 12 months
3 secondary outcomes
Change in LV relative wall thickness
Time frame: 6 and 12 months
Change in N-terminal pro-brain natriuretic peptide (NT-proBNP)
Time frame: 6 and 12 months
Change in LV mass index (g/m2)
Time frame: 6 months
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jun 2015.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Thomas Cappola, MD principal investigator
University of Pennsylvania
Gerald Dorn, MD principal investigator
Washington University School of Medicine
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Eplerenone in people with Hypertension, run by Washington University School of Medicine at 2 sites in United States.
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 6 inclusion and 15 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: withdrawn, as of the sponsor's last update on 3 Jun 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in United States. 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. Some participants in this study may receive a placebo. 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 withdrawn before enrolling participants, so there are no results.
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 in LV mass index (g/m2) in ClC-Ka Gly/Gly83 patients and ClC-Ka Gly/Gly83 patients (time frame: 12 months). 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 3 Jun 2015.