The Evaluation of Clevidipine in Patients Requiring ICP Monitoring and IV Antihypertensive Therapy

• ClinicalTrials.gov Identifier: NCT01910532
• Recruitment Status: Withdrawn
• First Posted: July 29, 2013
• Last Update Posted: July 29, 2013
• Sponsor: Mario Ammirati
• Information provided by (Responsible Party): Mario Ammirati, Ohio State University

Study Description

Brief Summary:

This is a single-arm, open label safety and dose titration study evaluating the use of Clevidipine to rapidly control elevated blood pressure in patients who have an Intracranial Pressure Monitoring device.

Condition or disease	Intervention/treatment	Phase
Hypertension	Drug: Clevidipine	Phase 4

Detailed Description:

This is a single-arm, open label safety and dose titration study evaluating the use of Clevidipine to rapidly control elevated blood pressure in patients who have an Intracranial Pressure Monitoring device.

All patients in which ICP monitoring is carried out need to maintain Cerebral Perfusion Pressure (CPP) within a tight range (typically, 70-90 mmHg) in order to avoid secondary brain injuries related to either too high or too low CPP. In this context there are clear benefits associated with a medication that is able to control hypertensive situations quickly and that lends itself to easy and reliable modulation.

Clinical studies have demonstrated that Clevidipine is an effective antihypertensive agent with a rapid onset and offset of action, and a favorable safety profile. Clevidipine has a predictable dose-response profile and is readily titrated to achieve individualized pharmacodynamic effects.

The investigators reasoned that Clevidipine could be an effective anti-hypertensive agent in this cohort of patients in which there is a need for rapid and precise blood pressure control. It is further hypothesized that improved blood pressure control in this patient population may result in the reduction in the severity of their neurological impairment.

The question to be answered is as follows: Is Clevidipine highly effective in achieving and maintaining Blood Pressure control in patients with hypertension (Systolic Blood Pressure > 160 mm Hg) and who require an Intracranial Pressure Monitoring Device?

Clevidipine will be highly effective in achieving and maintaining Blood Pressure control in patients with hypertension and who require an Intracranial Pressure Monitoring Device.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 0 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: The Evaluation of Clevidipine in Patients Requiring ICP Monitoring and IV Antihypertensive Therapy
• Study Start Date: April 2010
• Actual Primary Completion Date: November 2012
• Actual Study Completion Date: November 2012

Arms and Interventions

Arm	Intervention/treatment
Experimental: Clevidipine; Using Clevidipine for the treatment of acute hypertension defined SBP > 160 mmHg in patients who require an Intracranial Pressure Monitoring Device	Drug: Clevidipine; Clevidipine for the treatment of acute hypertension defined SBP > 160 mmHg in patients who require an Intracranial Pressure Monitoring Device

Outcome Measures

Primary Outcome Measures :

1. Time to achieve target Systolic Blood Pressure within 30 minutes of start of Celevidipine infusion [ Time Frame: Up to 1 year ]
   To evaluate the efficacy of Clevidipine for the treatment of acute hypertension during the first 30 minutes after initiation of the intravenous infusion in patients who require an Intracranial Pressure Monitoring Device

Secondary Outcome Measures :

1. Percentage of patients who reach target Systolic Blood Pressure within 30 minutes of start of Clevidipine infusion [ Time Frame: Up to 1 year ]
   To evaluate the efficacy of Clevidipine to maintain Systolic Blood Pressure (SBP) within the target range after the first 30 minutes of an initial infusion and up to 3 hours in patients who required an Intracranial Pressure Monitoring
2. Percentage of patients in who the Systolic Blood Pressure is maintained within the target range for up to 3 hours after the first 30 minutes of the start of Clevidipine infusion [ Time Frame: Up to 1 year ]

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. Male or female, 18 years or older
2. Written informed consent from the patient or their legal representative family member before initiation of any study-related procedures
3. Patients who clinically require Intracranial Pressure Monitoring device
4. Patients who have baseline systolic blood pressure (SBP) (immediately prior to initiation of Clevidipine) > 160 mmHg measured using an arterial line
5. Patients who required IV antihypertensive therapy to achieve SBP ≤ 160 mm Hg

Exclusion Criteria:

1. Patients who are prisoners
2. Patients who received an oral antihypertensive medication within 2 hours prior to initiation of Clevidipine
3. Patients who received any other IV antihypertensive medication within 2 hours prior to initiation of Clevidipine
4. Patients who have fixed dilated pupils and/or absence of gag and oculo-cephalic brain stem reflexes
5. Patients with a history of allergy or intolerance to calcium channel blockers
6. Patients with a history of allergy to soybean oil or egg lecithin
7. Patients who have participated or are currently participating in a clinical trial of an investigational drug within 30 days prior to enrollment
8. Patients who have acute myocardial infarction (AIM) on presentation
9. Patients who have known or suspected aortic dissection
10. Females who are pregnant or are breastfeeding
11. Patients with a history of liver failure, cirrhosis or pancreatitis
12. Patients with a prior directive against advanced life support
13. Patients with a history of impaired lipid metabolism
14. Patients with a history of severe aortic stenosis

Contacts and Locations

Locations

United States, Ohio

The Ohio State University Medical Center

Columbus, Ohio, United States, 43210

Sponsors and Collaborators

Mario Ammirati

Investigators

• Principal Investigator: Mario Ammirati, MD; Ohio State University

More Information

• Responsible Party: Mario Ammirati, Professor, Ohio State University
• ClinicalTrials.gov Identifier: NCT01910532
• Other Study ID Numbers: 2009H0336
• First Posted: July 29, 2013
• Last Update Posted: July 29, 2013
• Last Verified: July 2013

Additional relevant MeSH terms:

Hypertension; Vascular Diseases; Cardiovascular Diseases; Clevidipine; Calcium Channel Blockers; Membrane Transport Modulators; Molecular Mechanisms of Pharmacological Action; Calcium-Regulating Hormones and Agents; Physiological Effects of Drugs