A Dose Escalation Study of a Combination Antihypertensive Drug in the Treatment of Various Groups of Patients Who do Not Respond to Single Drug Treatment of Their High Blood Pressure (BP CRUSH)
This study has been completed.
Sponsor:
Daiichi Sankyo Inc.
Collaborator:
Integrium
Information provided by:
Daiichi Sankyo Inc.
ClinicalTrials.gov Identifier:
NCT00791258
First received: November 13, 2008
Last updated: September 30, 2010
Last verified: September 2010
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Results First Received: September 2, 2010
| Study Type: | Interventional |
|---|---|
| Study Design: | Endpoint Classification: Safety/Efficacy Study; Intervention Model: Single Group Assignment; Masking: Open Label; Primary Purpose: Treatment |
| Condition: |
Hypertension |
| Interventions: |
Drug: amlodipine and olmesartan medoxomil tablets Drug: hydrochlorothiazide tablets |
Participant Flow
Recruitment Details
| Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations |
|---|
| Recruitment occurred at approximately 140 outpatient medical clinics in the United States and South Africa from December 2008 through March 2009. 1406 uncontrolled hypertensive subjects were screened to place 999 subjects into active treatment. |
Pre-Assignment Details
| Significant events and approaches for the overall study following participant enrollment, but prior to group assignment |
|---|
| No text entered. |
Reporting Groups
| Description | |
|---|---|
| Olmesartan Medoxomil/Amlodipine Tablets + Hydrochlorothiazide | Amlodipine and olmesartan medoxomil (Azor) oral tablets and hydrochlorothiazide oral tablets (if necessary) will be administered once a day for up to 20 weeks |
Participant Flow: Overall Study
| Olmesartan Medoxomil/Amlodipine Tablets + Hydrochlorothiazide | |
|---|---|
| STARTED | 999 |
| COMPLETED | 736 |
| NOT COMPLETED | 263 |
| Adverse Event | 87 |
| Lost to Follow-up | 18 |
| Protocol Violation | 109 |
| Withdrawal by Subject | 40 |
| Did not take medication for >3 days | 1 |
| subject left area | 2 |
| non-compliance | 3 |
| Subject incarcerated | 1 |
| Subject required restricted medication | 1 |
| Lack of Efficacy | 1 |
Baseline Characteristics
Reporting Groups
| Description | |
|---|---|
| Olmesartan Medoxomil/Amlodipine Tablets + Hydrochlorothiazide | Amlodipine and olmesartan medoxomil (Azor) oral tablets and hydrochlorothiazide oral tablets (if necessary) will be administered once a day for up to 20 weeks |
Baseline Measures
| Olmesartan Medoxomil/Amlodipine Tablets + Hydrochlorothiazide | |
|---|---|
|
Number of Participants
[units: participants] |
999 |
|
Age
[units: participants] |
|
| <=18 years | 0 |
| Between 18 and 65 years | 771 |
| >=65 years | 228 |
|
Gender
[units: participants] |
|
| Female | 491 |
| Male | 508 |
|
Race (NIH/OMB)
[units: Participants] |
|
| American Indian or Alaska Native | 6 |
| Asian | 129 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 234 |
| White | 630 |
| More than one race | 0 |
| Unknown or Not Reported | 0 |
|
Region of Enrollment
[units: participants] |
|
| United States | 732 |
| South Africa | 267 |
|
Hispanic or Latino
[units: Participants] |
|
| Hispanic or Latino | 105 |
| Non-Hispanic or Latino | 894 |
|
Type 2 Diabetes
[units: Participants] |
|
| Yes | 192 |
| No | 807 |
|
Weight
[units: kg] Mean ± Standard Deviation |
88.20 ± 21.466 |
|
Body Mass Index
[units: Kg/m٨2] Mean ± Standard Deviation |
31.02 ± 6.370 |
|
Metabolic syndrome
[1] [units: Participants] |
|
| Yes | 462 |
| No | 537 |
|
Mean seated systolic blood pressure
[units: mm Hg] Mean ± Standard Deviation |
153.66 ± 9.178 |
|
Mean seated diastolic blood pressure
[units: mm Hg] Mean ± Standard Deviation |
91.92 ± 8.616 |
|
Pulse rate
[units: beats/minute] Mean ± Standard Deviation |
74.77 ± 11.621 |
|
24-Hour mean systolic ambulatory blood pressure
[units: mm Hg] Mean ± Standard Deviation |
135.74 ± 11.698 |
|
24-Hour mean diastolic ambulatory blood pressure
[units: mm Hg] Mean ± Standard Deviation |
81.09 ± 9.346 |
| [1] | Metabolic syndrome is defined as having at least 3 of the following parameters: waist circumference ≥40 inches (males) or ≥35 inches (females); triglycerides ≥150 mg/dL; high density lipoprotein cholesterol <40 mg/dL (males) or <50 mg/dL (females); blood pressure ≥130/85 mmHg; fasting glucose ≥100mg/dL; BMI ≥30kg/m2. |
|---|
Outcome Measures
| 1. Primary: | The Percentage of Patients Who Achieve Seated Systolic Blood Pressure Goal (<140 mm Hg for Non-diabetics and <130 mm Hg for Diabetics) From Baseline to 12 Weeks [ Time Frame: baseline to 12 weeks ] |
| 2. Secondary: | The Percentage of Subjects Achieving Seated Diastolic BP Goal (<90 mmHg for Non-diabetics or < 80 mmHg for Subjects With Diabetes) From Baseline to 12 Weeks [ Time Frame: baseline to 12 weeks ] |
| 3. Secondary: | The Percentage of Subjects Who Achieve BP Goal (<140/90 mmHg for Non-diabetics or <130/80 mmHg for Diabetics) From Baseline to 12 and 20 Weeks [ Time Frame: Baseline to 12 and 20 weeks ] |
| 4. Secondary: | Change in Mean Seated Systolic Blood Pressure From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 5. Secondary: | Change in Mean Seated Diastolic Blood Pressure From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 6. Secondary: | Percentage of Patients Achieving Seated Diastolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 7. Secondary: | Percentage of Patients Achieving Seated Systolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 8. Secondary: | Percentage of Patients Achieving Seated Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 9. Secondary: | Percentage of Patients Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 10. Secondary: | Percentage of Patients Achieving Seated Diastolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 11. Secondary: | Percentage of Participants Achieving the Mean Daytime Blood Pressure Goals, as Measured by Ambulatory Blood Pressure Monitor, From Baseline to 12 Weeks [ Time Frame: Baseline to 12 weeks ] |
| 12. Secondary: | Percentage of Participants Achieving the Mean Daytime Blood Pressure Goals, as Measured by Ambulatory Blood Pressure Monitor, From Baseline to 20 Weeks [ Time Frame: Baseline to 20 weeks ] |
| 13. Secondary: | Percentage of Participants Achieving the Mean Nighttime Blood Pressure Goals, as Measured by Ambulatory Blood Pressure Monitor, From Baseline to 12 Weeks [ Time Frame: Baseline to 12 weeks ] |
| 14. Secondary: | Percentage of Participants Achieving the Mean Nighttime Blood Pressure Goals, as Measured by Ambulatory Blood Pressure Monitor, From Baseline to 20 Weeks [ Time Frame: Baseline to 20 weeks ] |
| 15. Secondary: | Percentage of Participants Achieving the Mean 24-hour Blood Pressure Goals, as Measured by Ambulatory Blood Pressure Monitor, From Baseline to 12 Weeks [ Time Frame: Baseline to 12 weeks ] |
| 16. Secondary: | Percentage of Participants Achieving the Mean 24-hour Blood Pressure Goals, as Measured by Ambulatory Blood Pressure Monitor, From Baseline to 20 Weeks [ Time Frame: Baseline to 20 weeks ] |
| 17. Secondary: | Change From Baseline to Week 12 in Ambulatory Systolic and Diastolic Blood Pressure Values [ Time Frame: Baseline to 12 weeks ] |
| 18. Secondary: | Change From Baseline to Week 20 in Ambulatory Systolic and Diastolic Blood Pressure Values [ Time Frame: Baseline to 20 weeks ] |
| 19. Secondary: | Percentage of African American/Black Patients Achieving Seated Systolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 20. Secondary: | Percentage of African American/Black Patients Achieving Seated Diastolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 21. Secondary: | Percentage of African American/Black Patients Achieving Seated Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 22. Secondary: | Percentage of African American/Black Patients Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 23. Secondary: | Percentage of African American/Black Patients Achieving Seated Diastolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 24. Secondary: | Percentage of Asian Patients Achieving Seated Systolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 25. Secondary: | Percentage of Asain Patients Achieving Seated Diastolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 26. Secondary: | Percentage of Asian Patients Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 27. Secondary: | Percentage of Asian Patients Achieving Seated Diastolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 28. Secondary: | Percentage of Hispanic Patients Achieving Seated Systolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 29. Secondary: | Percentage of Hispanic Patients Achieving Seated Diastolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 30. Secondary: | Percentage of Hispanic Patients Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
Hide Outcome Measure 30| Measure Type | Secondary |
|---|---|
| Measure Title | Percentage of Hispanic Patients Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks |
| Measure Description | No text entered. |
| Time Frame | Baseline to 4, 8, 12, 16, 20 weeks |
| 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. |
|---|
| The analysis population consists of those Hispanic participants who have a baseline and at least 1 post-baseline measurement and who received at least one dose of study medication. However, the number of participants included will vary because of missing data and the number of dropouts. |
Reporting Groups
| Description | |
|---|---|
| Olmesartan Medoxomil/Amlodipine Tablets + Hydrochlorothiazide | Amlodipine and olmesartan medoxomil (Azor) oral tablets and hydrochlorothiazide oral tablets (if necessary) will be administered once a day for up to 20 weeks |
Measured Values
| Olmesartan Medoxomil/Amlodipine Tablets + Hydrochlorothiazide | |
|---|---|
|
Number of Participants Analyzed
[units: participants] |
98 |
|
Percentage of Hispanic Patients Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks
[units: Percentage of Participants] |
|
| 4 weeks: ≤ 15 mm Hg, N=98 | 50.0 |
| 4 weeks: >15 and ≤ 30 mm Hg, N=98 | 37.8 |
| 4 weeks: >30 and ≤ 45 mm Hg, N=98 | 7.1 |
| 4 weeks: >45 mm Hg, N=98 | 5.1 |
| 8 weeks: ≤ 15 mm Hg, N=91 | 42.9 |
| 8 weeks: >15 and ≤ 30 mm Hg, N=91 | 44.0 |
| 8 weeks: >30 and ≤ 45 mm Hg, N=91 | 9.9 |
| 8 weeks: >45 mm Hg, N=91 | 3.3 |
| 12 weeks: ≤ 15 mm Hg, N=83 | 31.3 |
| 12 weeks: >15 and ≤ 30 mm Hg, N=83 | 36.1 |
| 12 weeks: >30 and ≤ 45 mm Hg, N=83 | 25.3 |
| 12 weeks: >45 mm Hg, N=83 | 7.2 |
| 16 weeks: ≤ 15 mm Hg, N=75 | 22.7 |
| 16 weeks: >15 and ≤ 30 mm Hg, N=75 | 36.0 |
| 16 weeks: >30 and ≤ 45 mm Hg, N=75 | 34.7 |
| 16 weeks: >45 mm Hg, N=75 | 6.7 |
| 20 weeks: ≤ 15 mm Hg, N=71 | 23.9 |
| 20 weeks: >15 and ≤ 30 mm Hg, N=71 | 33.8 |
| 20 weeks: >30 and ≤ 45 mm Hg, N=71 | 33.8 |
| 20 weeks: >45 mm Hg, N=71 | 8.5 |
No statistical analysis provided for Percentage of Hispanic Patients Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks
| 31. Secondary: | Percentage of Hispanic Patients Achieving Seated Diastolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 32. Secondary: | Percentage of Elderly Patients Achieving Seated Systolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 33. Secondary: | Percentage of Elderly Patients Achieving Seated Diastolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 34. Secondary: | Percentage of Elderly Patients Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 35. Secondary: | Percentage of Elderly Patients Achieving Seated Diastolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 36. Secondary: | Percentage of Type 2 Diabetic Patients Achieving Seated Systolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 37. Secondary: | Percentage of Type 2 Diabetic Patients Achieving Seated Diastolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 38. Secondary: | Percentage of Type 2 Diabetic Patients Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 39. Secondary: | Percentage of Type 2 Diabetic Patients Achieving Seated Diastolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 40. Secondary: | Percentage of Obese Patients Achieving Seated Systolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 41. Secondary: | Percentage of Obese Patients Achieving Seated Diastolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 42. Secondary: | Percentage of Obese Patients Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 43. Secondary: | Percentage of Obese Patients Achieving Seated Diastolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 44. Secondary: | Percentage of Patients With Metabolic Syndrome Achieving Seated Systolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 45. Secondary: | Percentage of Patients With Metabolic Syndrome Achieving Seated Diastolic Blood Pressure Goal From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 46. Secondary: | Percentage of Patients With Metabolic Syndrome Achieving Seated Systolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 47. Secondary: | Percentage of Patients With Metabolic Syndrome Achieving Seated Diastolic Blood Pressure Reduction Ranges From Baseline to 4, 8, 12, 16, 20 Weeks [ Time Frame: Baseline to 4, 8, 12, 16, 20 weeks ] |
| 48. Secondary: | Percentage of Participants Previously on a Dihydropyridine Calcium Channel Blocker Achieving the Blood Pressure Goals From Baseline to 12 Weeks [ Time Frame: Baseline to 12 weeks ] |
| 49. Secondary: | Percentage of Participants Previously on a Dihydropyridine Calcium Channel Blocker Achieving the Blood Pressure Goals From Baseline to 20 Weeks [ Time Frame: Baseline to 20 weeks ] |
| 50. Secondary: | Percentage of Participants Previously on a Diuretic Achieving the Blood Pressure Goals From Baseline to 12 Weeks [ Time Frame: Baseline to 12 weeks ] |
| 51. Secondary: | Percentage of Participants Previously on a Diuretic Achieving the Blood Pressure Goals From Baseline to 20 Weeks [ Time Frame: Baseline to 20 weeks ] |
| 52. Secondary: | Percentage of Participants Previously on an Angiotensin Converting Enzyme Inhibitor Achieving the Blood Pressure Goals From Baseline to 12 Weeks [ Time Frame: Baseline to 12 weeks ] |
| 53. Secondary: | Percentage of Participants Previously on an Angiotensin Converting Enzyme Inhibitor Achieving the Blood Pressure Goals From Baseline to 20 Weeks [ Time Frame: Baseline to 20 weeks ] |
| 54. Secondary: | Percentage of Participants Previously on an Angiotensin II Receptor Blocker Achieving the Blood Pressure Goals From Baseline to 12 Weeks [ Time Frame: Baseline to 12 weeks ] |
| 55. Secondary: | Percentage of Participants Previously on an Angiotensin II Receptor Blocker Achieving the Blood Pressure Goals From Baseline to 20 Weeks [ Time Frame: Baseline to 20 weeks ] |
| 56. Secondary: | Percentage of Participants Previously on a Beta Blocker Achieving the Blood Pressure Goals From Baseline to 12 Weeks [ Time Frame: Baseline to 12 weeks ] |
| 57. Secondary: | Percentage of Participants Previously on a Beta Blocker Achieving the Blood Pressure Goals From Baseline to 20 Weeks [ Time Frame: Baseline to 20 weeks ] |
| 58. Secondary: | Percentage of Participants Previously on a Nondihydropyridine Calcium Channel Blocker Achieving the Blood Pressure Goals From Baseline to 12 Weeks [ Time Frame: Baseline to 12 weeks ] |
| 59. Secondary: | Percentage of Participants Previously on a Nondihydropyridine Calcium Channel Blocker Achieving the Blood Pressure Goals From Baseline to 20 Weeks [ Time Frame: Baseline to 20 weeks ] |
More Information
Certain Agreements:
Limitations and Caveats
Results Point of Contact:
No publications provided by Daiichi Sankyo Inc.
Publications automatically indexed to this study:
| 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:
|
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:
No publications provided by Daiichi Sankyo Inc.
Publications automatically indexed to this study:
| Responsible Party: | Diector of Medical Research and Strategy, Daiichi Sankyo |
| ClinicalTrials.gov Identifier: | NCT00791258 History of Changes |
| Other Study ID Numbers: | CS8663-404 |
| Study First Received: | November 13, 2008 |
| Results First Received: | September 2, 2010 |
| Last Updated: | September 30, 2010 |
| Health Authority: | United States: Food and Drug Administration |