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Trial record 1 of 1 for:    QGC001-3QG2 | Hypertension
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Randomized Study of Extended Treatment With Firibastat in Treatment-Resistant Hypertension (REFRESH) (REFRESH)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04857840
Recruitment Status : Recruiting
First Posted : April 23, 2021
Last Update Posted : September 20, 2021
Sponsor:
Collaborator:
PRA Health Sciences
Information provided by (Responsible Party):
Quantum Genomics SA

Brief Summary:
This is a double-blind, placebo-controlled and open-label, multicenter efficacy and long-term safety study of firibastat (QGC001) 1000 mg (2×500 mg tablets) administered po, QD, for up to 48 weeks in patients with difficult-to-treat/treatment-resistant HTN. Subjects will continue to take their chronic antihypertensive therapies (at least 2 classes of antihypertensive therapies) at the MTDs during the Run in Period and for the duration of the study. For treatment-resistant subjects, one of the antihypertensive therapies must be a diuretic; for difficult-to-treat subjects, the antihypertensive therapies do not have to include a diuretic. Subjects will complete subject medication diaries during the Run-in Period. If systolic automated office BP (AOBP) is ≥180 mmHg or diastolic BP (DBP) ≥110 mmHg at any visit during the study (and repeated and confirmed within 30 min), the subject will be withdrawn from the study and will receive appropriate treatment.

Condition or disease Intervention/treatment Phase
Hypertension (HTN) Drug: Firibastat (QGC001) Period 1 Phase 3

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 750 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: 2 Arms : Double-blind placebo controlled during Period 1 of 12 weeks followed by open-label periods 2 (24 weeks) and 3 (12 weeks)
Masking: Double (Participant, Care Provider)
Masking Description: Random allocation of the double blinded 2 Arms : Double-blind placebo controlled during Period 1 of 12 weeks
Primary Purpose: Treatment
Official Title: A Phase 3, Double-blind, Placebo-controlled and Open-label Efficacy and Long-term Safety Study of Firibastat (QGC001) Administered Orally, Once Daily, for Up to 48 Weeks in Patients With Difficult-to-treat/Resistant Hypertension.
Actual Study Start Date : August 5, 2021
Estimated Primary Completion Date : September 20, 2023
Estimated Study Completion Date : July 21, 2024

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Arm A: Investigational Product /Period 1,2 and 3 if any (open label)
Firibastat 1000 mg tablets QD - 12 weeks
Drug: Firibastat (QGC001) Period 1
1000 mg (2 x 500 mg) tablets QD per Os
Other Name: Firibastat (QGC001) Open label

Placebo Comparator: Arm B: Placebo/Period1 only
Placebo tablets QD 12 weeks in Period 1 only, followed by open label Period 2 and 3 if any.
Drug: Firibastat (QGC001) Period 1
1000 mg (2 x 500 mg) tablets QD per Os
Other Name: Firibastat (QGC001) Open label




Primary Outcome Measures :
  1. The primary efficacy endpoint is the change from baseline in systolic AOBP at Week 12. [ Time Frame: 12 weeks ]
    The main criterion will be analyzed with a mixed model with repeated measures (MMRM) at Week 6 (Day 42) and Week 12 (Day 84), with an unstructured matrix of covariance.



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Ages Eligible for Study:   18 Years to 99 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Able to understand and willing to provide written informed consent, and able to comply with the study procedures and restrictions.
  • Adult men and women (at Screening).
  • Diagnosis of primary HTN for at least 6 months prior to Screening and:

    • Currently treated with 2 antihypertensive classes of drug (difficult-to-treat subjects), or currently treated with at least 3 antihypertensive classes of drug including a diuretic (treatment resistant subjects), at the MTDs of those medications (ie, the subject can tolerate the current dose of each medication but higher doses have caused or may worsen side effects), with no change in their antihypertensive regimen (drug, dose, or schedule) for at least 6 weeks, and with medication adherence ≥80% during the Run in Period.
    • Have a systolic AOBP between 140 mmHg and 179 mmHg (inclusive) at Screening while on their current chronic antihypertensive treatments.
    • Have a successful ABPM measurement with a mean systolic daytime ABP >135 mmHg after the Run-in Period while on their current chronic antihypertensive treatments. An ABPM is successful if at least 21 daytime readings and 6 nighttime readings have been successfully recorded.
  • Women of childbearing potential and nonsurgically sterile male subjects who are sexually active must agree to use an approved highly effective form of contraception from the time of informed consent until 30 days post dose. Approved forms of contraception include hormonal intrauterine devices, hormonal contraceptives (oral birth control pills, depo, patch, or injectable) together with supplementary barrier methods such as condoms or diaphragms with spermicidal gel or foam.
  • Women of childbearing potential must have a negative serum pregnancy test result at Screening and a negative urine pregnancy test result at the Inclusion Visit (Visit 2B, Day 1)

Exclusion Criteria:

  • Target population:

Subjects with uncontrolled primary HTN despite being treated with at least 2 classes of antihypertensive therapies, at the MTDs (difficult-to-treat or treatment-resistant patients).

Inclusion criteria:

Subjects who meet all of the following criteria will be eligible to participate in the study:

  1. Able to understand and willing to provide written informed consent, and able to comply with the study procedures and restrictions.
  2. Adult men and women (at Screening).
  3. Diagnosis of primary HTN for at least 6 months prior to Screening and:

    • Currently treated with 2 antihypertensive classes of drug (difficult-to-treat subjects), or currently treated with at least 3 antihypertensive classes of drug including a diuretic (treatment resistant subjects), at the MTDs of those medications (ie, the subject can tolerate the current dose of each medication but higher doses have caused or may worsen side effects), with no change in their antihypertensive regimen (drug, dose, or schedule) for at least 6 weeks, and with medication adherence ≥80% during the Run in Period.
    • Have a systolic AOBP between 140 mmHg and 179 mmHg (inclusive) at Screening while on their current chronic antihypertensive treatments.
    • Have a successful ABPM measurement with a mean systolic daytime ABP >135 mmHg after the Run-in Period while on their current chronic antihypertensive treatments. An ABPM is successful if at least 21 daytime readings and 6 nighttime readings have been successfully recorded.
  4. Women of childbearing potential and nonsurgically sterile male subjects who are sexually active must agree to use an approved highly effective form of contraception from the time of informed consent until 30 days post dose. Approved forms of contraception include hormonal intrauterine devices, hormonal contraceptives (oral birth control pills, depo, patch, or injectable) together with supplementary barrier methods such as condoms or diaphragms with spermicidal gel or foam.
  5. Women of childbearing potential must have a negative serum pregnancy test result at Screening and a negative urine pregnancy test result at the Inclusion Visit (Visit 2B, Day 1).

Exclusion criteria:

Subjects who meet any of the following criteria will be excluded from participation in the study:

  1. Known or suspected secondary HTN (eg, hyperaldosteronism, renovascular HTN, pheochromocytoma, Cushing's disease).
  2. Systolic AOBP ≥180 mmHg or DBP ≥110 mmHg at the Screening or Inclusion Visit (Visit 2B, Day 1) and confirmed by a second measurement within 30 minutes to 1 hour.
  3. Known hypertensive retinopathy (Keith-Wagener Grade 3 or Grade 4) and/or hypertensive encephalopathy.
  4. Upper arm circumference that is outside the limits of the study-provided BP cuff associated with either the ABPM and/or AOBP measurement device.
  5. History of spontaneous or drug-induced angioedema.
  6. History of any drug-related allergy or hypersensitivity to any components of the IP (firibastat [QGC001] or placebo).
  7. Known severe aortic stenosis (symptomatic or asymptomatic with valvular indexed surface <0.5 cm²/m²).
  8. Subjects with severe symptomatic heart failure (New York Heart Association [NYHA] Class III or Class IV).
  9. History of acute coronary syndrome (non-ST elevation myocardial infarction [MI], ST elevation MI, and unstable angina pectoris), stroke, or transient ischemic attack within 6 months prior to Visit 2A, Day 0.
  10. Known history of malabsorption syndrome, or has undergone gastrointestinal surgery, including bariatric procedures that induce chronic malabsorption, within 2 years of Screening.
  11. Treatment with anti-obesity drugs or procedures 3 months prior to Screening (ie, surgery, aggressive diet regimen, etc.), leading to unstable body weight.
  12. Female who is breastfeeding, pregnant, or planning to become pregnant during the study period.
  13. Medical history of cancer (except for basal cell carcinoma) and/or treatment for cancer within the last 3 years.
  14. Shift workers who routinely sleep during the daytime and/or whose work hours include midnight.
  15. Subjects with moderate to severe hepatic impairment (Child-Pugh A, B, or C); alanine aminotransferase (ALT), aspartate aminotransferase (AST), or alkaline phosphatase (ALP) >3×upper limit of normal (ULN), or a total bilirubin ≥1.5×ULN (unless secondary to Gilbert's syndrome), or direct bilirubin >ULN in subjects with Gilbert's syndrome at Screening.
  16. Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2, as calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula (Levey AS, et al. 2009) at Screening.
  17. History of any blood disorder, other than sickle cell trait, causing hemolysis or unstable red blood cells (eg, malaria, babesiosis, hemolytic anemia, thalassemia, sickle cell anemia).
  18. Subjects with documented DI.
  19. Subjects with Type 1 diabetes mellitus.
  20. Subjects with Type 2 diabetes mellitus who:

    • Are poorly controlled, defined as glycosylated hemoglobin A1c (HbA1c) >9% at Screening; OR
    • Are taking short-acting insulin. Use of a stable dose [≥12 weeks prior to Screening] of the following medications, (or any combination of the following medications) is permitted: glucagon like peptide 1 analog, metformin, sulfonylurea, dipeptidyl peptidase-4 inhibitor, and single basal insulin, sodium glucose co-transporter 2 (SGLT2) inhibitors and pioglitazone.
  21. Routine or anticipated treatment with any systemic corticosteroid. Use of topical, inhaled, intra articular or nasal corticosteroids is permitted.
  22. Clinical evidence of thyroid disease, thyroid hormone therapy that is not stable ≥4 weeks prior to Screening, or a thyroid-stimulating hormone (TSH) level <0.75×lower limit of normal or >1.5×ULN at Screening.
  23. History of alcohol or drug abuse (including opioid overuse/misuse) within the 3 months prior to Screening that would interfere with study participation or lead to decreased compliance to study procedures or IP intake in the investigator's opinion.
  24. Participation in another clinical study involving an investigational drug within 30 days prior to Screening or plans to participate in another clinical study within 30 days of discontinuation of IP.
  25. Any other condition that precludes adequate understanding, cooperation, and compliance with study procedures or any condition that could pose a risk to the subject's safety, as per the investigator's judgment.
  26. Subjects with a life expectancy of less than 1 year per investigator's discretion.
  27. Legal incapacity or limited legal capacity.
  28. Previous participation in any clinical study with firibastat (QGC001).
  29. Subjects with any history of documented allergic reactions or allergic diseases, with the exception of documented seasonal allergies (per the investigator's decision).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04857840


Contacts
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Contact: Bruno BB BESSE, MD +33185347773 bruno.besse@quantum-genomics.com
Contact: Dalila DN Nafi, PHD +331 85 34 77 77 dalila.nafi@quantum-genomics.com

Locations
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United States, Virginia
Manassas Clinical Research Center Recruiting
Manassas, Virginia, United States, 20110
Contact: Jyotsna Sanil    703-330-1112    jyotsna@andrawis.com   
Principal Investigator: Nabil NA ANDRAWIS, MD         
Canada, Ontario
Canadian Phase Onward Recruiting
Toronto, Ontario, Canada, M3J 0K2
Contact: lilia LE Lilia Eidelman    +1416-227-0543    lilia.eidelman@phaseonward.com   
Principal Investigator: Lew PLIAMM, MD         
Sponsors and Collaborators
Quantum Genomics SA
PRA Health Sciences
Investigators
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Study Chair: Georges GB BAKRIS, MD AHA Comprehensive Hypertension Center University of Chicago Medical Center
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Responsible Party: Quantum Genomics SA
ClinicalTrials.gov Identifier: NCT04857840    
Other Study ID Numbers: QGC001-3QG2
First Posted: April 23, 2021    Key Record Dates
Last Update Posted: September 20, 2021
Last Verified: September 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Hypertension
Vascular Diseases
Cardiovascular Diseases
Firibastat
Antihypertensive Agents