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HyponatremiaPhase 3INSIGHTNCT00550459

Effects of Titrated Oral Tolvaptan 15-60 mg Once Daily (QD) on Cognitive and Neurological Function in Elderly Hyponatremic Patients

A Phase 3 study testing Tolvaptan in people with Hyponatremia, run by Otsuka Pharmaceutical Development & Commercialization, Inc. at 12 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Demonstrate an improvement in the composite scores of validated neurocognitive tests in elderly subjects with chronic sub-clinical (i.e., asymptomatic) hyponatremia. Read more about this study

Who is it for?
Ages 50 years and older
Conditions the study is for
Hyponatremia
What is being tested?
Tolvaptan
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
57 participants
Where
12 sitesUnited States
Study dates
Aug 2007to Mar 2009
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Women and men 50 years of age or older.
  • Serum Sodium ≥123 and ≤ 134 mEq/L [mmol/L]at screening and baseline.
  • Subjects with serum sodium concentrations ≥118 and ≤122 mEq/L[mmol/L] at screening and baseline may be entered into the trial based on consultation and approval from the study medical monitor.

Who cannot join

  • Conditions or history which may present a safety concern to the subject or their offspring or extreme susceptibility to hypotension with sudden fluid loss (aquaresis).
  • Hyponatremia that is acute, easily reversible, artifactual, or due to a condition not associated with vasopressin excess or likely to respond to aquaretic therapy.
  • Conditions associated with an independent imminent risk of morbidity and mortality.
  • Conditions which may confound the assessment of endpoints, history of poor compliance, participation in a clinical trial believed by the PI or Sponsor likely to confound endpoint assessments.
  • Conditions which may confound primary endpoints of cognitive function.

Trial locations and contacts

12 sites in 1 country.

12 sites in 1 country

United States12 sites
  • Mitchell Rosner, MD

    Charlottesville, Virginia, 22908

  • Pikes Peak Cardiology

    Colorado Springs, Colorado, 80907

  • Carolina Research Associates

    Columbia, South Carolina, 29201

  • Rockdale Medical Research Associates

    Conyers, Georgia, 30094

  • Lillestol Research, LLC

    Fargo, North Dakota, 58106

  • Sarah. S. Olelewe, MD

    Hawthorne, California, 90250

  • Memorial Clinical Associates

    Houston, Texas, 77043

  • Innovative Research of West FL

    Largo, Florida, 33770

  • Wayne O. Wells, MD

    Lebanon, Tennessee, 37087

  • Otis Barnum, DO

    Natchitoches, Louisiana, 71457

  • Coastal Nephrology Assoc. Research Center

    Punta Gorda, Florida, 33950

  • Progressive Clinical Research

    Vista, California, 92083

Other trials in United States

About this study

Official title: A Pilot, Phase 3B, Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel Group Study of the Effects of Titrated Oral Tolvaptan 15, 30, or 60 mg QD on Cognitive and Neurological Function in Elderly Hyponatremic Patients

Demonstrate an improvement in the composite scores of validated neurocognitive tests in elderly subjects with chronic sub-clinical (i.e., asymptomatic) hyponatremia.

Read the detailed description

Subjects will be randomized, with stratification by baseline sodium <130 or ≥ 130 mEq/L[mmol/L] to receive either tolvaptan 15 mg tablet or matching placebo tablet at doses of 15, 30 or 60 mg for 21 days. During this period, fluid restrictions should be loosened or suspended, until the subject's response to therapy can be evaluated, typically over the first few days of therapy. Fluid restriction may be reinstituted at any time in subjects whose sodium fails to improve or worsens with study therapy. A forced-titration up to 60 mg of study drug by day 3 to 7 will be based on the subject's serum sodium Subjects entering the study with a serum sodium concentration less than 130 mEq/L[mmol/L] may be fluid restricted if necessary at the discretion of the Investigator. Subjects should be monitored closely during the first 24 hours of treatment for dosing titration. The total dosing duration will be up to 21 days (plus 3 day treatment window). Subjects will return to the clinic on Day 22 (+3 days) for assessments and will complete a follow-up visit on Day 28 (+2 days).

Conditions
Hyponatremia
Being tested
Tolvaptan, Placebo
Keywords
Hyponatremia, Cognitive, Neurological Function, Elderly
Medical subject headings
Hyponatremia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TolvaptanDrug

    Also called OPC-41061

    15-60 mg oral tablet given once a day for 21 days.

  • PlaceboDrug

    Placebo tablet given once daily for 21 days

Study groups in NCT00550459
Study groupRoleWhat they receive
1Placebo comparatorPlacebo tablet given once a day for 21 days
Receives: Drug: Placebo
2Active comparatorTolvaptan 15 mg-60 mg tablet given once a day for 21 days.
Receives: Drug: Tolvaptan

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline in the Neurocognitive Composite Score of Speed Domains (NCS-SD; Sum of All Correct Speed Domain Z-Scores)

    Change from baseline to Day 22 in sum of all speed domain Z-scores:Reaction Time (Simple=recognize "yes" 50 times;Choice=recognize "yes" or "no" 50 times;Digit Vigilance=match 45 digits);Psychomotor Speed (Morse Tapping=tap button for 30 seconds with right \& left hands);Processing Speed (Rapid Visual Information Processing=detect consecutive sequences of 3 odd or 3 even digits;Numeric Working Memory=recognize numbers from series of 5 digits among 30;Word Recognition=remember 15 prior learned words from 30 total;results age-matched to healthy controls from Cognitive Drug Research normative data

    Measured: baseline and Day 22

Secondary outcomes (28)
  1. Change From Baseline to Day 22 in the Individual Neurocognitive Domains Included in the Primary Endpoint: Reaction Time in Computer Tests

    Change from baseline in the individual neurocognitive domains Z-score for Reaction Time in Computer Tests (simple reaction time test, choice reaction time test, digit vigilance test); ITT population

    Measured: baseline and Day 22

  2. Change From Baseline in the Individual Neurocognitive Domains Included in the Primary Endpoint: Psychomotor Speed Via Morse Tapping Test

    Change from baseline to Day 22 in the individual neurocognitive domains Z-score for Psychomotor Speed (mean tap rate of Morse tapping test); ITT population

    Measured: baseline and Day 22

  3. Change From Baseline in the Individual Neurocognitive Domains Included in the Primary Endpoint: Processing Speed of Rapid Visual Information Processing Test, Numeric Working Memory Test, and Word Recognition Test

    Change from baseline to Day 22 in the individual neurocognitive domains Z-score for Processing Speed of Rapid Visual Information Processing Test, Numeric Working Memory Test, and Word Recognition Test; ITT population

    Measured: baseline and Day 22

  4. Change From Baseline in Overall Neurocognitive Composite Score

    Change from Baseline to Day 22 in the overall Neurocognitive Composite Score (NCS)comprising the sum of 7 neurocognitive domain Z-scores (Reaction Time, Psychomotor Speed, Processing Speed, Continuity of Attention, Working Memory/Executive Functions, Quality of Episodic Verbal Memory, and Postural Stability); ITT population

    Measured: baseline and Day 22

  5. Change From Baseline in Gait Test (Timed Get-Up-and-Go Test)

    Change from baseline to Day 22 in Gait Test (Timed Get-Up-and-Go Test=time it takes for a seated subject to rise from a chair, walk 3 meters, walk around an object and return to sit in chair. Values: under 10 sec (no difficulties), 10 to 20 sec (starting to have balance difficulty), over 30 sec (at high risk for falls and dependent in most activities of daily living and mobility); test assesses risk to elderly subjects of falling and higher scores in seconds indicate higher risk of falling; ITT population

    Measured: baseline and Day 22

  6. Change From Baseline in Postural Stability Test

    Change from baseline to Day 22 in Postural Stability Test Z-score (This test measures gross motor control. The ability to stand upright without moving is assessed using the SWAY meter that is modeled on the Wright Ataxiameter. A cord from the meter is attached to the subject who is required to stand as still as possible with feet apart and eyes closed for 1 minute. The test is then repeated with eyes open for 1 minute. The outcomes of these tests are combined and measured as a movement Z-score. Higher result=better postural stability); ITT population

    Measured: baseline and Day 22

  7. Change From Baseline in Serum Sodium; ITT Population

    Change from Baseline to Day 22 in Serum Sodium; ITT population

    Measured: Baseline and Day 22

  8. Number of Patients With Vital Sign Abnormalities: Blood Pressure

    Incidence of abnormal systolic \& diastolic blood pressure values post-baseline (abnormal systolic values: >=180 mmHg + increase of >=20 mmHg, <= 90 mmHg + decrease >=20 mmHg; abnormal diastolic values: >=105 mmHg+increase of >=15 mmHg, <=50 mmHg + decrease of >= 15 mmHg)

    Measured: 28 days

  9. Number of Patients With Vital Sign Abnormalities: Pulse Rate

    Incidence of abnormal pulse rate post-baseline [abnormal values: >=120 beats per minute (bpm) + increase of >=15 bpm; <=50 bpm + decrease of >=15 bpm]

    Measured: 28 days

  10. Number of Patients With Vital Sign Abnormalities: Body Weight

    Incidence of clinically significant body weight change post-baseline (defined as change upward or downward of >=7%)

    Measured: 28 days

  11. Number of Patients With Vital Sign Abnormalities: Body Temperature

    Incidence of potentially clinically significant changes in body temperature post-baseline (defined as an increase of >=1.1 to >=38.3 degrees Celsius)

    Measured: 28 days

  12. Number of Patients With Hematology Laboratory Abnormalities: Hemoglobin

    Incidence of clinically significant hemoglobin abnormalities post-baseline (normal range=11.8-16.8 g/dL)

    Measured: 28 days

  13. Number of Patients With Hematology Laboratory Abnormalities: Activated Partial Thromboplastin Time (aPTT)

    Incidence of potentially clinically significant Activated Partial Thromboplastin Time (aPTT) levels post-baseline (normal range=22-34 seconds)

    Measured: 28 days

  14. Number of Patients With Hematology Laboratory Abnormalities: Lymphocytes

    Incidence of potentially clinically significant lymphocyte count post-baseline (normal range = 16-46%)

    Measured: 28 days

  15. Number of Patients With Hematology Laboratory Abnormalities: Neutrophils

    Incidence of potentially clinically significant neutrophil count post-baseline (normal range=1.8-8 thousands/microliter)

    Measured: 28 days

  16. Number of Patients With Serum Chemistry Laboratory Abnormalities: Blood Urea Nitrogen (BUN)

    Incidence of potentially clinically significant BUN levels post-baseline (normal range=7-30 mg/dL)

    Measured: 28 days

  17. Number of Patients With Serum Chemistry Laboratory Abnormalities: Uric Acid

    Incidence of potentially clinically significant uric acid levels post-baseline (normal range=4-8.5 mg/dL)

    Measured: 28 days

  18. Number of Patients With Serum Chemistry Laboratory Abnormalities: Cholesterol

    Incidence of potentially clinically significant cholesterol levels post-baseline (normal range=0-199 mg/dL)

    Measured: 28 days

  19. Number of Patients With Serum Chemistry Laboratory Abnormalities: Glucose

    Incidence of potentially clinically significant glucose levels post-baseline (normal range=70-125 mg/dL)

    Measured: 28 days

  20. Number of Patients With Serum Chemistry Laboratory Abnormalities: Magnesium

    Incidence of potentially clinically significant magnesium levels post-baseline (normal range=1.2-2 mEq/L)

    Measured: 28 days

  21. Number of Patients With Electrocardiogram (ECG) Abnormalities: QT >500 Milliseconds (Msec)

    Incidence of potentially clinically significant ECG abnormalities (QT>500 msec) post-baseline

    Measured: 28 days

  22. Number of Patients With Electrocardiogram (ECG) Abnormalities: QRS Interval

    Incidence of potentially clinically significant ECG abnormalities involving QRS interval (change > 100 msec)

    Measured: 28 days

  23. Number of Patients With Electrocardiogram (ECG) Abnormalities: QTcB Increase 30-60 Msec

    Incidence of potentially clinically significant ECG abnormalities (QTcB increase 30-60 msec)

    Measured: 28 days

  24. Number of Patients With Electrocardiogram (ECG) Abnormalities: QTcF Increase 30-60 Msec

    Incidence of potentially clinically significant ECG abnormalities (QTcF increase 30-60 msec post-baseline)

    Measured: 28 days

  25. Number of Patients With Electrocardiogram (ECG) Abnormalities: ST Segment

    Incidence of potentially clinically significant ECG abnormalities: ST Segment

    Measured: 28 days

  26. Number of Patients With Electrocardiogram (ECG) Abnormalities: T Wave

    Incidence of potentially clinically significant ECG abnormalities: T wave

    Measured: 28 days

  27. Number of Patients With Electrocardiogram (ECG) Abnormalities: Right Bundle Branch Block (RBBB), Left Bundle Branch Block (LBBB), Myocardial Infarction (MI)

    Incidence of potentially clinically significant ECG abnormalities: Right bundle branch block (RBBB), Left bundle branch block (LBBB), myocardial infarction (MI)

    Measured: 28 days

  28. Number of Patients With Electrocardiogram (ECG) Abnormalities: Arrhythmia

    Incidence of potentially clinically significant ECG abnormalities: arrhythmia

    Measured: 28 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Oct 2007 (estimated)
  2. Study startAug 2007
  3. Primary completionFeb 2009
  4. Study completionMar 2009

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
57 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00550459
Sponsor's protocol ID
156-04-246
Other IDs
INSIGHT
Acronym
INSIGHT
Status last verified
Apr 2011
First submitted
25 Oct 2007
Last updated
28 Apr 2011
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Tolvaptan in people with Hyponatremia, run by Otsuka Pharmaceutical Development & Commercialization, Inc. at 12 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Apr 2011. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Apr 2011). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline in the Neurocognitive Composite Score of Speed Domains (NCS-SD; Sum of All Correct Speed Domain Z-Scores) (time frame: baseline and Day 22). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Apr 2011.

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