Efficacy Study of PDE-5 Inhibitor and Calcium Channel Inhibitor for the Treatment of Secondary Raynaud Phenomenon
- Full Text View
- Tabular View
- Study Results
- Disclaimer
- How to Read a Study Record
Purpose
The prevalence of Raynaud phenomenon (RP), a reversible vaso-constriction with skin discoloration, is 5-10% in general population. Often conventional measures such as warming up or minimizing exposure to cold are not enough and many patients require treatment with a vasodilator therapy. A recent study showed a good efficacy and safety profile of sildenafil, a selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) in RP.
Here, the investigators aim to examine the efficacy and safety of Udenafil, a newer PDE5 inhibitor, as compared to amlodipine, a well known calcium channel blocker, in the treatment of secondary RP in Korean patients.
| Condition | Intervention | Phase |
|---|---|---|
|
Raynaud Phenomenon |
Drug: Udenafil or Amlodipine |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | Comparison of Phosphodiesterase-5 Inhibitor and Calcium Channel Inhibitor for the Treatment of Secondary Raynaud Phenomenon, Double Blind, Randomized, Cross-over Trial |
- RP Attacks Per Day [ Time Frame: baselin and 4 weeks ] [ Designated as safety issue: No ]Change in RP frequency after amlodipine and udenafil number of RP attack per day 0 -- unlimited.
- Change in Raynaud's Condition Score (RCS) [ Time Frame: baseline and 4 weeks ] [ Designated as safety issue: No ]
change in the RCS. RCS combines daily activty, frequency, duration and severity as well as impact of RP attack (Measuring disease activity and functional status in patients with scleroderma and Raynaud's phenomenon, Merkel et al,Arthritis Rheum. 2002 Sep;46(9):2410-20).
Range 0-10 ordinal scale 0..good 10.. bad
- Change in the RP Duration [ Time Frame: baseline and 4 weeks ] [ Designated as safety issue: No ]Change in the average RP duration in minutes (min) per attack. 0 -- unlimited
- Change in Health Assessment Questionnaire (HAQ) [ Time Frame: 0 and 4 weeks ] [ Designated as safety issue: No ]Ordinal scale 0-10 0 good 10 bad
- Change in Physician's Global Assessment on Visual Analogue Scale (VAS) [ Time Frame: at 0 (baseline) and 4 weeks (after treatment) ] [ Designated as safety issue: No ]
Physician's global assessment (PGA) on VAS assesses the overall condition of the patient. The scale ranges from 0 - 10, with 0 being good and 10 bad. As such, change in the GPA measures the change in the patient's condition from the baseline.
negative value (decrease in value) means improvement.
- Change in Digital Ulcer Number [ Time Frame: baseline and 4 weeks ] [ Designated as safety issue: No ]0 - unlimited. Number of digital ulcers in all fingers are counted by the investigators and recorded at each visit. The number of ulcers in all fingers indirectly reflect the extent of critical ischemia. As such. the decrease in digital ulcer number reflects positive response to treatment (=better blood flow), whereas the increase ulcer numbers indicates worsening finger ischemia from baseline.
- Change in Peak Systolic Flow (cm/Sec) [ Time Frame: baseline and 4 weeks ] [ Designated as safety issue: No ]
Change in digital artery flow velocity in proper palmar digital artery in cm/sec.
0-unlimited
- Time-averaged Peak Velocity (cm/Sec) [ Time Frame: baseline and 4 weeks ] [ Designated as safety issue: No ]changes in the averaged blood flow (Time-averaged peak velocity) Blood flow in cm/sec 0 - unlimited.
- Dorsal-digital-difference. [ Time Frame: baseline and 4 weeks ] [ Designated as safety issue: No ]The temperature difference between finger tips and dorsum of same hand. range 0 - unlimited in degree celcius.
| Enrollment: | 29 |
| Study Start Date: | January 2011 |
| Study Completion Date: | June 2011 |
| Primary Completion Date: | May 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Amlodipine-Udenafil (AU) arm
Amlodipine 10mg PO QD for 4 weeks, washout period, then Udenafil 100mg PO QD for 4 weeks
|
Drug: Udenafil or Amlodipine
Amlodipine 10mg daily then Udenafil 100 mg daily OR Udenafil 100 mg daily then Amlodipine 10mg daily
|
|
Experimental: Udenafil-Amlodipine (UA) arm
Udenafil 100mg PO QD for 4 weeks, washout period, then Amlodipine 10mg PO QD for 4 weeks
|
Drug: Udenafil or Amlodipine
Amlodipine 10mg daily then Udenafil 100 mg daily OR Udenafil 100 mg daily then Amlodipine 10mg daily
|
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- secondary Raynaud's phenomenon
Exclusion Criteria:
- primary raynaud phenomenon
- active infection
- hypersensitivity to PDE5 inhibitor or Calcium Chanel Blocker (CCB)
- elevated AST/ALT (3 times above the upper normal limit)
- severe renal failure
- patients on nitrite or nitric oxide (NO) donor treatment
- recent history of cerebrovascular accidents, acute myocardial infarction, or coronary artery bypass surgery
- hypotension (less than 90/50 mmHg) or uncontrolled hypertension
Contacts and Locations| Korea, Republic of | |
| Seoul National University Hospital | |
| Seoul, Korea, Republic of, 110-744 | |
| Principal Investigator: | Eun Bong Lee, MD PhD | professor of Seoul National University College of Medicine |
| Study Director: | Eun Young Lee, MD PhD | Assistant professor, Seoul National University College of Medicine |
| Study Director: | Jin Kyun Park, MD | Seoul National University Hospital |
More Information
No publications provided
| Responsible Party: | Eun Bong Lee, Direct, Division of Rheumatology, Seoul National University Hospital |
| ClinicalTrials.gov Identifier: | NCT01280266 History of Changes |
| Other Study ID Numbers: | RaynaudSNUH |
| Study First Received: | January 14, 2011 |
| Results First Received: | July 4, 2012 |
| Last Updated: | December 7, 2012 |
| Health Authority: | Korea: Food and Drug Administration |
Keywords provided by Seoul National University Hospital:
|
Pathological Conditions Signs and Symptoms Blood circulation |
Additional relevant MeSH terms:
|
Raynaud Disease Peripheral Vascular Diseases Vascular Diseases Cardiovascular Diseases Amlodipine Udenafil Phosphodiesterase 5 Inhibitors Calcium Channel Blockers Membrane Transport Modulators |
Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Cardiovascular Agents Therapeutic Uses Vasodilator Agents Antihypertensive Agents Phosphodiesterase Inhibitors Enzyme Inhibitors |
ClinicalTrials.gov processed this record on May 16, 2013