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The CLEVER Study - Coreg And Left Ventricular Mass Regression
This study has been completed.
Study NCT00108082   Information provided by GlaxoSmithKline
First Received: April 13, 2005   Last Updated: September 30, 2009   History of Changes
Study Type: Interventional
Study Design: Randomized, Double-Blind, Parallel Assignment
Conditions: Hypertension
Left Ventricular Hypertrophy
Interventions: Drug: carvedilol MR
Drug: atenolol
Drug: lisinopril

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
No text entered.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
Following screening, 413 participants were enrolled into the study to begin an open-label run-in phase with lisinopril 10 mg once daily (OD) for 1 week and then lisinopril 20 mg OD for 1 week. Of these participants, 287 were randomized to 1 of the 3 treatment regimens.

Reporting Groups
  Description
Carvedilol CR Carvedilol controlled release (CR) 20 to 80 mg once daily (OD) plus lisinopril 20 mg OD. Participants were titrated from the starting dosage to higher dosages until their blood pressure was controlled. Participants continued to receive lisinopril 20 mg OD throughout the study. (In the protocol, carvedilol CR was referred to as carvedilol modified-release [MR].)
Atenolol Atenolol 50 to 100 mg OD plus lisinopril 20 mg OD. Participants were titrated from the starting dosage to higher dosages until their blood pressure was controlled. Participants continued to receive lisinopril 20 mg OD throughout the study.
Lisinopril Lisinopril 10 to 40 mg OD plus lisinopril 20 mg OD. Participants were titrated from the starting dosage to higher dosages until their blood pressure was controlled. Participants continued to receive lisinopril 20 mg OD throughout the study.

Participant Flow:   Overall Study
  Carvedilol CR Atenolol Lisinopril
STARTED   91     100     96  
COMPLETED   53[1]   68[2]   53[3]
NOT COMPLETED   38     32     43  
      Adverse Event               14                 12                 17  
      Lost to Follow-up               6                 3                 7  
      Consent withdrawn               3                 3                 5  
      Protocol Violation               1                 2                 0  
      Lack of Efficacy               3                 1                 2  
      Amendment 4: > Month 12               5                 7                 5  
      Woman of child-bearing potential               2                 0                 2  
      Incorrectly randomized               0                 0                 2  
      Non-compliance               1                 0                 2  
      Other               3                 4                 1  
[1] Per protocol Amendment 4, participants who had completed Month 12 prior to amendment were withdrawn.
[2] Per protocol Amendment 4, participants who had completed Month 12 prior to amendment were withdrawn.
[3] Per protocol Amendment 4, participants who had completed Month 12 prior to amendment were withdrawn.



  Baseline Characteristics
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Reporting Groups
  Description
Carvedilol CR Carvedilol controlled release (CR) 20 to 80 mg once daily (OD) plus lisinopril 20 mg OD. Participants were titrated from the starting dosage to higher dosages until their blood pressure was controlled. Participants continued to receive lisinopril 20 mg OD throughout the study. (In the protocol, carvedilol CR was referred to as carvedilol modified-release [MR].)
Atenolol Atenolol 50 to 100 mg OD plus lisinopril 20 mg OD. Participants were titrated from the starting dosage to higher dosages until their blood pressure was controlled. Participants continued to receive lisinopril 20 mg OD throughout the study.
Lisinopril Lisinopril 10 to 40 mg OD plus lisinopril 20 mg OD. Participants were titrated from the starting dosage to higher dosages until their blood pressure was controlled. Participants continued to receive lisinopril 20 mg OD throughout the study.

Baseline Measures
  Carvedilol CR Atenolol Lisinopril Total
Number of Participants  
[units: participants]
91 100 96 287
Age  
[units: years]
Mean ± Standard Deviation
56.6 ± 10.53 57.4 ± 10.95 55.9 ± 10.09 56.7 ± 10.52
Gender  
[units: participants]
       
Female 40 41 47 128
Male 51 59 49 159
Race/Ethnicity, Customized  
[units: participants]
       
African American/African Heritage 17 26 17 60
American Indian/Alaska Native 0 1 1 2
Asian 2 1 0 3
White/Caucasian 67 67 72 206
Arabic/North African Heritage 1 0 1 2
Mixed Race 1 0 1 2
Not Reported 3 5 4 12



  Outcome Measures
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1.  Primary:   Model-adjusted Mean Change From Baseline in Left Ventricular Mass Indexed (LVMI) by Body Surface Area as Measured by Magnetic Resonance Imaging (MRI) at Month 12   [ Month 12 (If Month 12 data were not available, the Last Observation Carried Forward [LOCF] analysis, which includes data collected on or after Month 9 of treatment to Month 12 of treatment, was used) ]

2.  Secondary:   Model-adjusted Mean Change From Baseline in Left Ventricular Mass Indexed by Height (LVMIH) as Measured by MRI at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF analysis, which includes data collected on or after Month 9 of treatment to Month 12 of treatment, was used) ]

3.  Secondary:   Model-adjusted Mean Change From Baseline in Left Ventricular (LV) Mass as Measured by MRI at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF analysis, which includes data collected on or after Month 9 of treatment to Month 12 of treatment, was used) ]

4.  Secondary:   Model-adjusted Mean Change From Baseline in Left Ventricular Mass Indexed (LVMI) by Body Surface Area as Measured by Echocardiography at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF analysis, which includes data collected on or after Month 9 of treatment to Month 12 of treatment, was used) ]

5.  Secondary:   Model-adjusted Mean Change From Baseline in Left Ventricular Mass Indexed by Height (LVMIH) as Measured by Echocardiography at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF analysis, which includes data collected on or after Month 9 of treatment to Month 12 of treatment, was available) ]

6.  Secondary:   Model-adjusted Mean Change From Baseline in LV Mass as Measured by Echocardiography at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF analysis, which includes data collected on or after Month 9 of treatment to Month 12 of treatment, was used) ]

7.  Secondary:   Mean Change From Baseline in LV Filling Parameters as Measured by MRI at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF analysis, which includes data collected on or after Month 9 of treatment to Month 12 of treatment, was used) ]

8.  Secondary:   Model-adjusted Mean Change From Baseline in LV End Systolic and Diastolic Volumes and Ejection Fraction as Measured by MRI at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF analysis, which includes data collected on or after Month 9 of treatment to Month 12 of treatment, was used) ]

9.  Secondary:   Model-adjusted Mean Change From Baseline in LV End Systolic and Diastolic Volumes and Ejection Fraction as Measured by Echocardiography at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF analysis, which includes data collected on or after Month 9 of treatment to Month 12 of treatment, was used) ]

10.  Secondary:   Model-adjusted Mean Change From Baseline in Systolic and Diastolic Blood Pressure (BP) at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF analysis, which includes data collected on or after Month 9 of treatment to Month 12 of treatment, was used) ]

11.  Secondary:   Model-adjusted Ratio to Baseline as Percentage Change From Baseline in Log Transformed B-type Natriuretic Peptide (BNP) at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF was used ]

12.  Secondary:   Model-adjusted Ratio to Baseline as Percentage Change From Baseline in Log Transformed C-Reactive Protein (CRP) at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF was used) ]

13.  Secondary:   Percentage Change From Baseline in Log Transformed Lipid Parameters at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF was used) ]

14.  Secondary:   Model-adjusted Ratio to Baseline as Percentage Change From Baseline in Log Transformed Albumin Creatinine Ratio (ACR) at Month 12   [ Month 12 (If Month 12 data were not available, the LOCF was used) ]
  Hide Outcome Measure 14

Measure Type Secondary
Measure Title Model-adjusted Ratio to Baseline as Percentage Change From Baseline in Log Transformed Albumin Creatinine Ratio (ACR) at Month 12
Measure Description Urinary ACR (micrograms per milligram) was determined at Baseline and after 12 months of treatment/Month 12. Percentage change from Baseline was based on log transformed data and was calculated as 100 x (exponent (exponent (mean change on log scale) - 1. [Change in Baseline was calculated as Month 12 value (or value after 12 months of treatment) minus the Baseline value.]
Time Frame Month 12 (If Month 12 data were not available, the LOCF was used)  
Safety Issue No  

Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
All randomized participants who had a valid measurements at Baseline and Month 12 (LOCF)

Reporting Groups
  Description
Carvedilol CR Carvedilol controlled release (CR) 20 to 80 mg once daily (OD) plus lisinopril 20 mg OD. Participants were titrated from the starting dosage to higher dosages until their blood pressure was controlled. Participants continued to receive lisinopril 20 mg OD throughout the study. (In the protocol, carvedilol CR was referred to as carvedilol modified-release [MR].)
Atenolol Atenolol 50 to 100 mg OD plus lisinopril 20 mg OD. Participants were titrated from the starting dosage to higher dosages until their blood pressure was controlled. Participants continued to receive lisinopril 20 mg OD throughout the study.
Lisinopril Lisinopril 10 to 40 mg OD plus lisinopril 20 mg OD. Participants were titrated from the starting dosage to higher dosages until their blood pressure was controlled. Participants continued to receive lisinopril 20 mg OD throughout the study.

Measured Values
  Carvedilol CR Atenolol Lisinopril
Number of Participants Analyzed
[units: participants]
40 51 38
Model-adjusted Ratio to Baseline as Percentage Change From Baseline in Log Transformed Albumin Creatinine Ratio (ACR) at Month 12
[units: percentage]
Geometric Mean ( 95% Confidence Interval )
-27.1
( -39.9 to -11.6 )
-20.1
( -32.4 to -5.5 )
-21.5
( -35.2 to -4.8 )

No statistical analysis provided for Model-adjusted Ratio to Baseline as Percentage Change From Baseline in Log Transformed Albumin Creatinine Ratio (ACR) at Month 12




  Serious Adverse Events
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  Other Adverse Events
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  More Information
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Certain Agreements:  
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
The agreement is:
unchecked The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days. The sponsor cannot require changes to the communication and cannot extend the embargo.
unchecked The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo.


Limitations and Caveats
Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
No text entered.  


Results Point of Contact:  
Name/Title: GSK Response Center
Organization: GlaxoSmithKline
phone: 866-435-7343


No publications provided


Responsible Party: GSK ( Study Director )
Study ID Numbers: COR100216
Study First Received: April 13, 2005
Results First Received: August 13, 2009
Last Updated: September 30, 2009
ClinicalTrials.gov Identifier: NCT00108082     History of Changes
Health Authority: United States: Food and Drug Administration