Study of Nifedipine GITS and Candesartan Combination Compared to Monotherapy in Patients With Essential Hypertension (DISTINCT)

This study has been completed.
Information provided by (Responsible Party):
Bayer Identifier:
First received: February 24, 2011
Last updated: June 5, 2015
Last verified: June 2015
The purpose of this study is to determine the blood pressure lowering responses of various dose combinations of nifedipine GITS and candesartan as compared to treatment with each component on their own (monotherapy) and placebo (a look-alike tablet without active ingredient). The drugs - nifedipine GITS and candesartan - which are being investigated are currently approved for use in patients with essential hypertension alone or together with other antihypertensive drugs (combination therapy), but the optimal dose of nifedipine GITS and candesartan used together in the treatment of essential hypertension has not been established yet. In this study patients will be treated with various doses of nifedipine GITS and/or candesartan or placebo. These different regimes will be administered once a day and will be assessed based on their blood pressure lowering effects (mean sitting diastolic blood pressure) in subjects with mild to moderate essential hypertension.

Condition Intervention Phase
Drug: Candersartan
Drug: Nifedipine (Adalat, BAYA1040)
Drug: Nifedipine GITS/Candersartan
Drug: Placebo
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Multicenter, Multifactorial, Randomized, Double-Blind, Placebo-Controlled Dose Finding Study of Nifedipine GITS and Candesartan in Combination Compared to Monotherapy in Adult Patients With Essential Hypertension

Resource links provided by NLM:

Further study details as provided by Bayer:

Primary Outcome Measures:
  • The primary efficacy variable is the change from baseline in mean seated diastolic blood pressure (MSDBP) at Week 8 [ Time Frame: Baseline taken at Visit 1; primary outcome variable assesed at 8 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Change in mean seated systolic blood pressure (MSSBP) at Week 8 [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  • Control rate at Week 8 [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  • Response rate at Week 8 [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  • Peripheral Edema [ Time Frame: 8 weeks ] [ Designated as safety issue: Yes ]

Enrollment: 1381
Study Start Date: April 2011
Study Completion Date: May 2012
Primary Completion Date: May 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm 1 Drug: Candersartan
Candersartan 8 mg
Experimental: Arm 2 Drug: Candersartan
Candersartan 16 mg
Experimental: Arm 3 Drug: Candersartan
Candersartan 32 mg
Experimental: Arm 4 Drug: Nifedipine (Adalat, BAYA1040)
Nifedipine GITS 20 mg
Experimental: Arm 5 Drug: Nifedipine (Adalat, BAYA1040)
Nifedipine GITS 30 mg
Experimental: Arm 6 Drug: Nifedipine (Adalat, BAYA1040)
Nifedipine GITS 60 mg
Experimental: Arm 7 Drug: Nifedipine GITS/Candersartan
Nifedipine GITS/Candersartan 20/8 mg
Experimental: Arm 8 Drug: Nifedipine GITS/Candersartan
Nifedipine GITS/Candersartan 30/8 mg
Experimental: Arm 9 Drug: Nifedipine GITS/Candersartan
Nifedipine GITS/Candersartan 60/8 mg
Experimental: Arm 10 Drug: Nifedipine GITS/Candersartan
Nifedipine GITS/Candersartan 20/16 mg
Experimental: Arm 11 Drug: Nifedipine GITS/Candersartan
Nifedipine GITS/Candersartan 30/16 mg
Experimental: Arm 12 Drug: Nifedipine GITS/Candersartan
Nifedipine GITS/Candersartan 60/16 mg
Experimental: Arm 13 Drug: Nifedipine GITS/Candersartan
Nifedipine GITS/Candersartan 20/32 mg
Experimental: Arm 14 Drug: Nifedipine GITS/Candersartan
Nifedipine GITS/Candersartan 30/32 mg
Experimental: Arm 15 Drug: Nifedipine GITS/Candersartan
Nifedipine GITS/Candersartan 30/16 mg (1 week) => Nifedipine GITS/Candersartan 30/32 mg (7 weeks)
Placebo Comparator: Arm 16 Drug: Placebo
Placebo once daily in the morning


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Male and female subjects 18 years or older. Female subjects must be either post-menopausal for one year, surgically sterile, or using an effective contraceptive method. Hormonal contraceptive use is disallowed.
  • Subjects must have mild to moderate essential hypertension (Grade 1 and 2 WHO classifications) as measured by calibrated standard sphygmomanometer. (MSDBP of ≥90 mmHg and < 110 mmHg at Visit 1 (placebo run-in), and MSDBP of ≥95 mmHg and < 110 mmHg at visit 2 (randomization)
  • Subjects must have an absolute difference in their MSDBP of less than 10 mmHg between Visit 1 (placebo run- in) and Visit 2 (randomization).

Exclusion Criteria:

  • Severe hypertension (Grade 3 WHO classification; MSDBP ≥110 mmHg and/or MSSBP ≥ 180 mmHg)
  • Inability to washout of antihypertensive drugs (even if prescribed for another indication) safely for a period of 14 weeks.
  • History of hypertensive retinopathy - known Keith-Wagener Grade III or IV
  • History of hypertensive encephalopathy
  • Cerebrovascular ischemic event (stroke, transient ischemic attack [TIA])within the previous 12 months
  • History of intracerebral hemorrhage or subarachnoid hemorrhage
  • Evidence of secondary hypertension such as coarchation of the aorta, pheochromocytoms, hypersaldosteronism, etc.
  • Type I diabetes mellitus (DM) or poorly controlled DM Type II as evidenced by a glycosylated hemoglobin [HbA1C] of greater than 9% on visit 1.
  • Allergies or known intolerance to one of the investigational drugs/drug class or to one of their ingredients
  • Any history of heart failure, New York Heart Association (NYHA) classification III or IV
  • Severe coronary heart disease as manifest by a history of myocardial infarction or unstable angina in the last 6 months prior to visit 1.
  • Clinically significant cardiac valvular disease
  • History of malignancy in the last 5 years, excluding basal or skin cancer
  • Uncorrected hypokalemia or hyperkalemia: potassium outside 3.0-5.0 mmol/L
  • Surgical or medical conditions that might alter the metabolism, excretion or distribution or absorption of any drug

    1. Gastrointestinal disease or surgery resulting in the potential for malabsorption
    2. Severe gastrointestinal tract narrowing; kock pouch (ileostomy after proctocolectomy)
    3. Cholestasis or biliary obstruction or history of pancreatic injury or clinical significant increase of lipase, amylase, or bilirubin.
    4. Liver disease or AST/ALT levels >3 x ULN
    5. Renal failure, creatinine level >1.4 mg/dL, or on hemodialysis
  • Investigation trial participation with receipt of investigational study drug within the last month
  • Previous assignment to treatment in this study
  • Female subjects who are pregnant or lactating.
  • Subjects who have night employment (night shift).
  • Subjects with an aortic aneurysm that, in the opinion of the investigator, will be unsuitable to be enrolled in the study.
  • Thought by the investigator for any reason to be unsuitable for participation in a clinical study
  • Systemic use of known cytochrome P450-3A4 inhibitors (e.g cimetidine, anti-human immunodeficiency virus [HIV] protease inhibitors e.g. ritonavir, azole anti-mycotics eg. ketoconazole,) or inducers (e.g rifampicin, anti-epileptic drugs eg. phenytoin, carbamazepine and phenobarbitone) or some P450-3A4 substrates (e.g quinidine, digoxin, tacrolimus)
  • Present severe rhythm or conduction disorder:
  • Atrial fibrillation
  • Second or third degree heart block without a pacemaker.
  • Baseline QTc >450 msec
  • History of non-compliance, alcoholism or drug abuse that in the opinion of the investigator will compromise successful completion of the study.
  • If differences greater than 20 mmHg for SBP and 10 mmHg for DBP are present on 3 consecutive BP readings, the subject should be excluded from the study.
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Please refer to this study by its identifier: NCT01303783

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Sponsors and Collaborators
Study Director: Bayer Study Director Bayer
  More Information

Additional Information:
No publications provided by Bayer

Additional publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Bayer Identifier: NCT01303783     History of Changes
Other Study ID Numbers: 14725  2009-017077-37 
Study First Received: February 24, 2011
Last Updated: June 5, 2015
Health Authority: Argentina: Administracion Nacional de Medicamentos, Alimentos y Tecnologia Medica
Belgium: Federal Agency for Medicinal Products and Health Products
Brazil: Ministry of Health
Canada: Canadian Institutes of Health Research
Italy: National Monitoring Centre for Clinical Trials - Ministry of Health
Lithuania: State Medicine Control Agency - Ministry of Health
Russia: Pharmacological Committee, Ministry of Health
South Africa: Department of Health
South Korea: Ministry for Health, Welfare and Family Affairs
Spain: Ministry of Health
Ukraine: State Pharmacological Center - Ministry of Health
United Kingdom: National Institute for Health Research
United States: Food and Drug Administration

Keywords provided by Bayer:
Nifedipine GITS
mild to moderate Hypertension
Combination therapy

Additional relevant MeSH terms:
Cardiovascular Diseases
Vascular Diseases
Candesartan cilexetil
Angiotensin II Type 1 Receptor Blockers
Angiotensin Receptor Antagonists
Antihypertensive Agents
Calcium Channel Blockers
Cardiovascular Agents
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Reproductive Control Agents
Therapeutic Uses
Tocolytic Agents
Vasodilator Agents processed this record on February 04, 2016