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HypertensionSMARTNCT02761811

Sympathetic Mapping/ Ablation of Renal Nerves Trial

A study testing SyMapCath I™ catheter and SYMPIONEER S1™ Stimulator/Generator in people with Hypertension, run by SyMap Medical (Suzhou), Ltd. at 15 sites in China.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

To evaluate the safety and efficacy of targeted renal sympathetic denervation using SyMapCath I® and SYMPIONEER S1® Stimulator/ Generator in patients with essential hypertension for at least 6 months of the disease history and pharmacotherapy, however, their blood pressure still cannot be controlled, then after… Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Hypertension
What is being tested?
SyMapCath I™ catheter and SYMPIONEER S1™ Stimulator/Generator
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
220 participants
Where
15 sitesChina
Study dates
30 Jun 2016to 31 Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male and non-pregnant female subjects, 18≤age≤65
  • Essential hypertension
  • Office systolic blood pressure ≥150mmHg and ≤180mmHg; and resting heart rate ≥70 bpm without taking beta blocker(Resting heart rate does not taken into account if beta blocker is taken)
  • Average 24-hour ABPM systolic blood pressure ≥130mmHg, or ABPM systolic blood pressure during daytime ≥ 135mmHg, or ABPM systolic blood pressure during nighttime ≥ 120mmHg
  • History of hypertension is longer than 6 months
  • Patient with poor blood pressure control after 6 months of antihypertensive drug therapy, understands the purpose of this study, and is willing to participate and sign the Informed Consent; then the patient receives standard antihypertensive drug treatment (at least two drugs) for at least 28 days, drug compliance ≥80%, office systolic blood pressure ≥150 mmHg and ≤180 mmHg.
  • Patient is compliant and willing to complete clinical follow-up.

Who cannot join

  • Renal artery anatomy is unqualified including: (1) diameter <4mm or treatable length <25mm, (2) multiple renal arteries and the main renal artery supplies a fraction of the blood flow less than 75%, (3) renal artery stenosis >50% or any renal artery aneurysms on either side, (4) history of renal artery PTA, including balloon angioplasty and stenting.
  • eGFR <45mL/min/1.73m2 (MDRD formula)
  • Hospitalized within one year due to hypertensive crisis
  • Average 24-hour systolic blood pressure <130mmHg and ABPM systolic blood pressure during daytime ≤ 135mmHg, and ABMP systolic blood pressure during nighttime ≤ 120mmHg
  • Pulse pressure >80mmHg
  • During running in period, using antihypertensive drugs other than standardized antihypertensive drugs
Show all 12Show fewer
  • Participated other clinical trials including both drug and medical device studies within 3 months from current study
  • Female with pregnant or lactating, or having plans for pregnancy within 1 year
  • Patient with sleep apnea who needs chronic oxygen-breathing or mechanical ventilation support (for example, tracheostomy)
  • Patients previously or currently suffering from following diseases:
  • essential pulmonary arterial hypertension, (2) type I diabetes, (3) patients with severe cardiac valvular stenosis who have contradictions and cannot rolerant to significantly reduce blood pressure, (4) within half year, patients had myocardial infraction, unstable angina, syncope or cerebrovascular accidents, (5) history of primary aldosteronism, pheochromocytoma, aorta stenosis, hyperthyroidism or hyperparathyreosis, (6) any disease conditions interfering the measurement of blood pressure (for instance, severe peripheral artery diseases, abdominal artery aneurysm, hemorrhagic disorders such as thrombocytopenia, hemophilia and severe anemia), (7) plans to have surgery or cardiovascular interventions within 6 months, (8) alcohol abuse or unknown drug dependence history, (9) neuroticisms such as depression or anxiety disorders, (10) non-compliant patients who are unable to follow the study protocol per physician's requests.
  • 11. Any contradictions to conduct renal artery stimulation and ablation

Trial locations and contacts

15 sites in 1 country.

15 sites in 1 country

China15 sites
  • Peking University First Hospital

    Beijing, Beijing Municipality, 100038

  • Peking University People's Hospital

    Beijing, Beijing Municipality, 100044

  • West China Hospital, Sichuan University

    Chengdu, Sichuan, 610041

  • The Second Afflicted Hospital of Chongqing Medical University

    Chongqing, Chongqing Municipality, 400016

  • Daqing Oilfield General Hospital

    Daqing, Heilongjiang, 163458

  • Nanjing First Hospital

    Nanjing, Jiangsu, 210000

  • Jiangsu Province Hospital

    Nanjing, Jiangsu, 210029

  • Shanghai Zhongshan Hospital, Fudan University

    Shanghai, Shanghai Municipality, 200032

  • Shenzhen People's Hospital

    Shenzhen, Guangdong, 518020

  • Norman Bethune International Peace Hospital

    Shijiazhuang, Hebei, 050000

  • Hebei General Hospital

    Shijiazhuang, Hebei, 050057

  • Taiyuan Central Hospital

    Taiyuan, Shanxi, 030009

  • Tianjin First Center Hospital

    Tianjin, Tianjin Municipality, 300192

  • Renmin Hospital of Wuhan University

    Wuhan, Hubei, 430060

  • The Affiliated Hospital of Xuzhou Medical University

    Xuzhou, Jiangsu, 221004

Other trials in China

About this study

Official title: A Prospective, Multicenter, Single Blind, Randomized and Sham Controlled Trial of Renal Sympathetic Denervation Using SyMapCath I™ Catheter and SYMPIONEER S1™ Stimulator/Generator for the Treatment of Hypertension (SMART Trial)

To evaluate the safety and efficacy of targeted renal sympathetic denervation using SyMapCath I® and SYMPIONEER S1® Stimulator/ Generator in patients with essential hypertension for at least 6 months of the disease history and pharmacotherapy, however, their blood pressure still cannot be controlled, then after standardized antihypertensive drug therapy (at least two drugs) for at least 28 days, office systolic blood pressure is still ≥ 150mmHg, ≤180mmHg.

Read the detailed description

This is a prospective, multicenter, single blind, randomized and sham controlled trial, in which patients are diagnosed with essential hypertension with at least six months of the disease history and pharmacotherapy however their blood pressure still cannot be controlled. The patients will be informed, consent and get into a screening process. During the screening period patients will receive a standardized antihypertensive drug treatment for at least 28 days and office systolic blood pressure is still ≥ 150mmHg, ≤180mmHg, and meet the inclusion and exclusion criteria. These patients will conduct renal artery angiography and be allocated to either renal sympathetic nerve denervation group or renal artery angiography group by a randomizing system in a 1:1 ratio (220 patients, 110 pairs). Patients with office systolic blood pressure which is not achieved ideal level (<140 mmHg) will titrate doses or classes of antihypertensive drugs according to a predefined standardized medication regimen until their office systolic blood pressure <140 mmHg, whereas in principle patients should follow the drug titration regimen, however, it is allowed to adjust antihypertensive medications per the real-world needs after 12 months.

Physicians who perform post-procedure patient management and physicians who perform renal denervation procedures are blinded to each other.

Patients will be followed at 7 days after the procedure or at discharge from hospital, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 9 months, 12months, 24months, 36 months, 48 months and 60 months for blood pressure measurements and antihypertensive medications. Urine samples will be collected for drug tests (LC-MS/MS) to determine drug compliance of a patient by an independent laboratory.

Data collecting/management/statistical analysis and laboratory tests will be done by independent, qualified organizations. Independent DSMB/CEC are formed and responsible for assessments of protocol deviations and natures of SAEs.

Conditions
Hypertension
Being tested
SyMapCath I™ catheter and SYMPIONEER S1™ Stimulator/Generator
Medical subject headings
Hypertension

What participants receive

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

  • SyMapCath I™ catheter and SYMPIONEER S1™ Stimulator/GeneratorDevice

    Radiofrequency ablation of renal arterial sympathetic nerves

Study groups in NCT02761811
Study groupRoleWhat they receive
Renal Sympathetic DenervationExperimentalPercutaneous renal denervation using the SyMapCath I™ Catheter and SYMPIONEER S1™ Stimulator/Generator.
Receives: Device: SyMapCath I™ catheter and SYMPIONEER S1™ Stimulator/Generator
Masked ProcedureSham comparatorPercutaneous renal artery angiography
Receives: Device: SyMapCath I™ catheter and SYMPIONEER S1™ Stimulator/Generator

What is being measured

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

  1. The control rate of office systolic blood pressure ( SBP<140mmHg)

    The control rate of office systolic blood pressure ( SBP<140mmHg) at 6 months after the treatment

    Measured: 6 months after the treatment

  2. Change in the composite index of antihypertensive drugs to reach control of office systolic blood pressure (<140mmHg)

    Change in the composite index of antihypertensive drugs to reach control of office systolic blood pressure (<140mmHg) at 6 months after the treatment

    Measured: 6 months after the treatments

Secondary outcomes (11)
  1. Reduction in average 24-hour Ambulatory Blood Pressure Monitoring (ABPM) systolic blood pressure

    Measured: 6 months

  2. Postoperative reduction in 24-hour ABPM in systolic, diastolic and mean arterial blood pressure

    Measured: discharge day or 7 days after procedure

  3. Reduction in office blood pressure

    Measured: 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 12 months, 24months, 36 months, 48 months and 60 months

  4. Change in composite index of antihypertensive drugs

    Measured: 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 12 months, 24months, 36 months, 48 months and 60 months

  5. Success rate of the renal interventional therapy procedure

    the renal denervation catheter can be engaged to the correct position in renal artery, successfully performed renal nerve ablation procedure and has no related complications such as renal arterial perforation

    Measured: during the procedure

  6. Success rate of clinical treatment

    based on succeed performance of renal interventional therapy procedure , there are no the procedure-related SAE, such as acute infection and renal dysfunction

    Measured: 7 days after the procedure or at the time the patient is discharged from hospital

  7. All-cause death

    Measured: 1 month, 3 months, 6 months, 9 months, 12 months, 24months, 36 months, 48 months and 60 months

  8. Severe renal dysfunction

    eGFR<15mL/min/m2 or renal function replacement therapy needed

    Measured: 6 months, 24months, 36 months, 48 months and 60 months

  9. Rate of renal artery stenosis assessed by CT angiography

    (stenosis > 70% )

    Measured: 6 months, 24months, 36 months, 48 months and 60 months

  10. AEs, SAEs, and severe cardio-cerebrovascular events

    Measured: 1 month, 3 months, 6 months, 9 months, 12months, 24months, 36 months, 48 months and 60 months

  11. Reduction in 24-hour ABPM in systolic and diastolic arterial blood pressure

    Measured: 24, 36, 48, 60 months

Timeline

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

  1. First posted4 May 2016 (estimated)
  2. Study start30 Jun 2016
  3. Primary completion25 Aug 2022
  4. Study completion31 Dec 2026 (estimated)

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
220 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02761811
Sponsor's protocol ID
2015-01
Acronym
SMART
Status last verified
Jul 2023
First submitted
3 May 2016
Last updated
2 Aug 2023
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Undecided: Our decision on whether to share the individual participant data depends on the opinions of the regulatory authorities in China, but so far the regulatory agencies have no clear instructions yet, thus we cannot make a decision at present.

Publications

  • Wang J, Yin Y, Lu C, Lu Z, Hu J, Wang Y, Ge J, Jiang H, Yao C, Yan X, Ma W, Qi X, Dang Y, Chen S, Zhu J, Wang D, Ding C, Wang W, Liu J, Wang Y, Li H, Pan Z, Cui K, Li C, Liang X, Chen W, Sobotka PA, Zhang J, Esler M, Sun N, Chen M, Huo Y. Efficacy and safety of sympathetic mapping and ablation of renal nerves for the treatment of hypertension (SMART): 6-month follow-up of a randomised, controlled trial. EClinicalMedicine. 2024 May 7;72:102626. doi: 10.1016/j.eclinm.2024.102626. eCollection 2024 Jun.

    PubMed 38756107
  • Wang J, Sun N, Ge J, Jiang H, Yin Y, Chen M, Wang Y, Yao C, Yan X, Sobotka PA, Huo Y. Rationale and Design of Sympathetic Mapping/Ablation of Renal Nerves Trial (SMART) for the Treatment of Hypertension: a Prospective, Multicenter, Single-Blind, Randomized and Sham Procedure-Controlled Study. J Cardiovasc Transl Res. 2023 Apr;16(2):358-370. doi: 10.1007/s12265-022-10307-z. Epub 2022 Aug 30.

    PubMed 36042146
  • Wang Y, Wang JW, Wang Y, Yang B, Yinghua Du A, Kong Z, Chen M, Wang J. Monitoring Antihypertensive Medication Adherence by Liquid Chromatography-Tandem Mass Spectrometry: Method Establishment and Clinical Application. J Cardiovasc Pharmacol. 2021 Oct 1;78(4):581-596. doi: 10.1097/FJC.0000000000001105.

    PubMed 34269698

Questions about this trial

What is this clinical trial studying?

A study testing SyMapCath I™ catheter and SYMPIONEER S1™ Stimulator/Generator in people with Hypertension, run by SyMap Medical (Suzhou), Ltd. at 15 sites in China.

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 7 inclusion and 12 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: under way, not looking for participants, as of the sponsor's last update on 2 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in China. 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.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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?

The control rate of office systolic blood pressure ( SBP<140mmHg) (time frame: 6 months after the treatment). The study lists 2 primary outcomes in all. 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 NCT02761811, which also lists 3 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 2 Aug 2023.

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