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Essential HypertensionNCT04554303

Comparing Safety and Efficacy of Amlodipine Verses S Amlodipine in Patients With Essential Hypertension

An observational study of Essential Hypertension, run by Ahn-Gook Pharmaceuticals Co.,Ltd at 1 site in South Korea.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

As a third-generation dihydropyridine calcium channel blocker (CCB), Amlodipine is mainly used in a single therapy or combined therapy for hypertension or angina. Edema, one of the most common side effects of dihydropyridine CCB formulations, may lead to drug control or discontinuation of drugs. Read more about this study

Who is it for?
Ages 19 years and older
Conditions the study is for
Essential Hypertension
What is being tested?
S-amlodipine 2.5mg and Amlodipine 5mg
Type of treatment
Pill or oral medicine
How many people
80 participants
Where
1 siteSouth Korea
Study dates
28 Oct 2020to 23 May 2022
Phase
Observational
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 19 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Ordinary patients with essential hypertension who visits the medical institution participating in this study, and volunteers to enroll in this study.

Who may be able to join

  • Patients with essential hypertension and diagnosed with stage 1-2 hypertension in accordance with the 2019 Korean Society of Hypertension criteria (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg)
  • Where a subject and his/her spouse (partner) have agreed to use medically acceptable contraceptives in the following during participation in this clinical study:
  • Use of intrauterine device with proven failure rate of pregnancy;
  • Simultaneous use of blocking contraception and spermicide;
  • Has had a vasectomy;
  • Has had a salpingectomy, tubal ligation, or hysterectomy;
  • Those who have made voluntary decisions to participate in this clinical study and have consented to the Informed Consent Form in writing;
  • Those who are able to understand and follow instructions and participate throughout the entire clinical study

Who cannot join

  • Patients with uncontrolled, high-risk hypertension (SBP≥180mm Hg and DBP≥110mm Hg);
  • Those who have a history of secondary hypertension and any history of suspected secondary hypertension (aortic congestion, hyperaldosteronism, renal artery stenosis, Cushing's disease, chromaffinoma, polycystic renal disease, etc.);
  • Those who fall under one or more of the following items that may cause edema without underlying diseases:
  • Those who have been diagnosed with myocardial infarction or heart failure within 6 months of screening;
  • Those who have been diagnosed with a cerebrovascular accident (CVA) within 6 months of screening;
  • Patients with renal failure requiring dialysis or those with edema caused by renal dysfunction (renal salt retention);
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  • Those who have uncontrolled diabetes (HbA1c> 10.0%) or diabetic edema;
  • Patients with severe liver dysfunction or edema caused by liver disease (cirrhosis);
  • Other patients with hypothyroidism, proteinuria, and problems at the joint or ankle joint
  • Those who have cerebrovascular disease, unstable angina, or transient ischemic attack, or those who have had coronary artery bypass graft or coronary angioplasty;
  • Patients who may develop edema by concomitant drugs at screening:
  • Drugs that constrict intrarenal blood vessels (e.g. nonsteroidal anti-inflammatory drugs, cyclosporine, etc.);
  • Drugs that dilate arterioles (e.g. vasodilators, etc.);
  • Drugs that increase sodium reabsorption in the kidneys (e.g. steroids, etc.);
  • Drugs that damage capillaries (e.g. interleukin-2, etc.);
  • Glitazone-based drugs for diabetes
  • Those who show hypersensitive reaction* to the investigational product;
  • Those who are taking the following drugs that may cause drug interactions:
  • Drugs that may change the plasma concentration of amlodipine [e.g. CYP3A4 inducers (e.g. rifampicin, St. John's wort (Hypericum perforatum), etc.);
  • Drugs that may increase the antihypertensive action [e.g. other antihypertensives (calcium channel blockers, beta blockers, ACEi, ARB, alpha blockers, diuretics, nitroglycerin), tricyclic antidepressants (amitriptyline, desipramine, imipramine, nortriptyline, protriptyline, trimipramine, etc.), nitrate formulation, baclofen, pioglitazone, sildenafil, etc.];
  • Systemic corticosteroids (fluocinolone, triamcinolone), etc.: Local application allowed;
  • Drugs that may increase the inhibitory action of muscle contraction [e.g. antiarrhythmics (amiodarone, quinidine, etc.);
  • Drugs that may cause ventricular spasms (e.g. intravenous administration of dantrolene and verapamil);
  • Drugs that may increase the risk of hypotension [e.g. CYP3A4 inhibitors (clarithromycin), etc.]
  • Patients in a state of chronic inflammation requiring chronic anti-inflammatory treatment;
  • Those who have participated in other interventional clinical studies within 6 months of screening;
  • Those who have been diagnosed as having malignant tumors within 5 years of screening;
  • Those who showed clinically significant abnormal results in electrocardiogram and laboratory tests at screening;
  • Those who are pregnant or lactating, or have been confirmed as being pregnant through the Urine HCG test;
  • Those who have been judged to be inappropriate to participate in the clinical study by the principal investigator or subinvestigator.

Trial locations and contacts

1 site in 1 country.

Jin Ho Kim, Master's contact

8207042335338

jhkim@dtnsm.com

Sun Kyung Lee, Bachelor's contact

8207041521475

sklee@dtnsm.com

South Korea1 site, 1 recruiting
  • Korea University Guro Hospital

    Seoul, 08308

    Eung-Ju Kim, Ph.D, 820226263022, withnoel@empas.com

    Eung-Ju Kim, Ph.D

    Recruiting

Other trials in South Korea

About this study

Official title: A 12 Weeks, Multi-center, Randomized, Open Label, Active Control, Phase IV Clinical Trial to Compare Evaluated Improvement of Edema Index, Safety and Efficacy of Amlodipine Versus S Amlodipine in Patients With Essential Hypertension

As a third-generation dihydropyridine calcium channel blocker (CCB), Amlodipine is mainly used in a single therapy or combined therapy for hypertension or angina.

Edema, one of the most common side effects of dihydropyridine CCB formulations, may lead to drug control or discontinuation of drugs.

This clinical study intends to assess the safety and efficacy of S-amlodipine, which is assessed to be superior to Amlodipine in the aspects of antihypertensive effect and side effects, in edema of patients with essential hypertension.

Read the detailed description
  1. Clinical Study Design
  • In this clinical study, Part 1 is conducted as a preliminary study on 10 subjects at a single center, and based on the results of Part 1, the sponsor and the principal investigator determine whether to proceed with Part 2. With Part 2 as the multicenter main study conducted on the remaining 70 subjects, 80 subjects in total have been planned for Part 1 and Part 2.
  1. Interim analysis
  • The interim analysis is conducted when the study on 10 subjects at a Part 1 single center has been completed; the analysis is made on all endpoints planned for this clinical study.
  1. Clinical study methods - During screening, subjects who have voluntarily signed the Informed Consent Form are tested for eligibility to this clinical study.

After a wash-out period of at least two weeks, subjects who satisfy the inclusion/exclusion criteria are randomly assigned to two groups (S-amlodipine group, Amlodipine group). Thereafter, the subjects are enrolled and orally administered with the investigational product once a day for 12 weeks, during which they receive a total of five visits for tests conducted for assessment of efficacy and safety.

(In case of confirmed eligibility without administration of contraindications, the wash-out period may be omitted and Visits 1 and 2 may be paid on the same day)

Being tested
S-amlodipine 2.5mg, Amlodipine 5mg
Keywords
Essential Hypertension, Amlodipine, S-Amlodipine, Hypertension, Blood Pressure, Edema
Medical subject headings
Essential Hypertension, Hypertension, Edema

What participants receive

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

  • S-amlodipine 2.5mgDrug

    Also called Levotension Tab.

    Oral administration, 1 tablet per day

  • Amlodipine 5mgDrug

    Also called Norvasc Tab.

    Oral administration, 1 tablet per day

Study groups in NCT04554303
Study groupRoleWhat they receive
S-amlodipine treatment groupPatients with essential hypertension, who satisfies all criteria listed in eligibility section are randomly assigned, after a wash-out period of at least two weeks.
Receives: Drug: S-amlodipine 2.5mg
Amlodipine treatment groupPatients with essential hypertension, who satisfies all criteria listed in eligibility section are randomly assigned, after a wash-out period of at least two weeks.
Receives: Drug: Amlodipine 5mg

What is being measured

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

  1. The variance in edema index [Extracellular water (ECW) / total body water (TBW)] using Inbody measurement between groups at week 12, compared to the baseline.

    Descriptive statistics (number of observation subjects, mean, standard deviation, median, minimum, maximum) are summarized by treatment group. Depending on whether there is a difference in the variance between treatment groups (S-amlodipine group, Amlodipine group) that satisfies the normality assumption, analysis is made using either two sample t-test or Wilcoxon's rank sum test.

    Measured: Edema indexs (ECW/TBW) are measured at week 4, 8, 12 of treatment.

Secondary outcomes (4)
  1. The variance in edema index between groups at weeks 4 and 8, compared to the baseline

    Descriptive statistics (number of observation subjects, mean, standard deviation, median, minimum, maximum) are summarized by treatment group. Depending on whether there is a difference in the variance between treatment groups (S-amlodipine group, Amlodipine group) that satisfies the normality assumption, analysis is made using either two sample t-test or Wilcoxon's rank sum test.

    Measured: Edema indexs (ECW/TBW) are measured at week 4, 8, 12 of treatment.

  2. The variance in ankle size (mean size of both ankles using a medical tape measure) between groups at weeks 4, 8, and 12, compared to the baseline.

    Mean size of both anckles are tape-measured using medical tape.

    Measured: Ankel sizes are measured in at week 4, 8, and 12 of treatment.

  3. The variance in edema index (extracellular moisture per site/water per site) by site (body, right arm, left arm, trunk, right leg, left leg) between groups at weeks 4, 8, and 12, compared to the baseline.

    Descriptive statistics (number of observation subjects, mean, standard deviation, median, minimum, maximum) are summarized by site(body, right arm, left arm, trunk, right leg, left leg) and treatment group. Depending on whether there is a difference in the variance between treatment groups (S-amlodipine group, Amlodipine group) that satisfies the normality assumption, analysis is made using either two sample t-test or Wilcoxon's rank sum test.

    Measured: Edema indexs (ECW/TBW) by site (body, right arm, left arm, trunk, right leg, left leg) are measured at the week 4, 8, and 12 of treatment.

  4. The variance in blood pressure between groups at weeks 4, 8, and 12, compared to the baseline.

    Blood pressure is measured at five-minute intervals after a five-minute rest while seated; three measurements are made for one arm and the SBP and DBP values at each measurement are collected and calculated to derive the mean value.

    Measured: Blood pressure are measured at week 4, 8, and 12 of treatment.

Timeline

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

  1. First posted18 Sep 2020
  2. Study start28 Oct 2020
  3. Primary completion23 May 2022 (estimated)
  4. Study completion23 May 2022 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04554303
Sponsor's protocol ID
AG-C1908
Status last verified
Sep 2020
First submitted
14 Sep 2020
Last updated
12 Nov 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Pathak L, Hiremath, Kerkar PG, Manade VG. Multicentric, clinical trial of S-Amlodipine 2.5 mg versus Amlodipine 5 mg in the treatment of mild to moderate hypertension--a randomized, double-blind clinical trial. J Assoc Physicians India. 2004 Mar;52:197-202.

    PubMed 15636308
  • Pedrinelli R, Dell'Omo G, Melillo E, Mariani M. Amlodipine, enalapril, and dependent leg edema in essential hypertension. Hypertension. 2000 Feb;35(2):621-5. doi: 10.1161/01.hyp.35.2.621.

    PubMed 10679507
  • Messerli FH. Vasodilatory edema: a common side effect of antihypertensive therapy. Curr Cardiol Rep. 2002 Nov;4(6):479-82. doi: 10.1007/s11886-002-0110-9.

    PubMed 12379167
  • Sener D, Halil M, Yavuz BB, Cankurtaran M, Ariogul S. Anasarca edema with amlodipine treatment. Ann Pharmacother. 2005 Apr;39(4):761-3. doi: 10.1345/aph.1E410. Epub 2005 Feb 22.

    PubMed 15728328
  • Brown NJ, Vaughan DE. Angiotensin-converting enzyme inhibitors. Circulation. 1998 Apr 14;97(14):1411-20. doi: 10.1161/01.cir.97.14.1411.

    PubMed 9577953
  • Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet. 2007 Jan 20;369(9557):201-7. doi: 10.1016/S0140-6736(07)60108-1.

    PubMed 17240286
  • Makani H, Bangalore S, Romero J, Htyte N, Berrios RS, Makwana H, Messerli FH. Peripheral edema associated with calcium channel blockers: incidence and withdrawal rate--a meta-analysis of randomized trials. J Hypertens. 2011 Jul;29(7):1270-80. doi: 10.1097/HJH.0b013e3283472643.

    PubMed 21558959
  • Galappatthy P, Waniganayake YC, Sabeer MI, Wijethunga TJ, Galappatthy GK, Ekanayaka RA. Leg edema with (S)-amlodipine vs conventional amlodipine given in triple therapy for hypertension: a randomized double blind controlled clinical trial. BMC Cardiovasc Disord. 2016 Sep 1;16(1):168. doi: 10.1186/s12872-016-0350-z.

    PubMed 27586538
  • Liu F, Qiu M, Zhai SD. Tolerability and effectiveness of (S)-amlodipine compared with racemic amlodipine in hypertension: a systematic review and meta-analysis. Curr Ther Res Clin Exp. 2010 Feb;71(1):1-29. doi: 10.1016/j.curtheres.2010.02.005.

    PubMed 24683248
  • Kim SA, Park S, Chung N, Lim DS, Yang JY, Oh BH, Tahk SJ, Ahn TH. Efficacy and safety profiles of a new S(-)-amlodipine nicotinate formulation versus racemic amlodipine besylate in adult Korean patients with mild to moderate hypertension: an 8-week, multicenter, randomized, double-blind, double-dummy, parallel-group, phase III, noninferiority clinical trial. Clin Ther. 2008 May;30(5):845-57. doi: 10.1016/j.clinthera.2008.05.013.

    PubMed 18555932
  • Schoeller DA, Alon A, Manekas D, Mixson LA, Lasseter KC, Noonan GP, Bolognese JA, Heymsfield SB, Beals CR, Nunes I. Segmental bioimpedance for measuring amlodipine-induced pedal edema: a placebo-controlled study. Clin Ther. 2012 Mar;34(3):580-92. doi: 10.1016/j.clinthera.2012.01.018. Epub 2012 Mar 3.

    PubMed 22385927

Questions about this trial

What is this clinical trial studying?

An observational study of Essential Hypertension, run by Ahn-Gook Pharmaceuticals Co.,Ltd at 1 site in South Korea.

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 8 inclusion and 30 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: status not confirmed, as of the sponsor's last update on 12 Nov 2020. 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 South Korea. 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.

Are results available for this study?

Results are not available in the source record.

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

Contact Jin Ho Kim, Master's (8207042335338, jhkim@dtnsm.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The variance in edema index [Extracellular water (ECW) / total body water (TBW)] using Inbody measurement between groups at week 12, compared to the baseline. (time frame: Edema indexs (ECW/TBW) are measured at week 4, 8, 12 of treatment.). 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 NCT04554303, which also lists 11 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 12 Nov 2020.

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