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Heart FailurePhase 3NCT00775840

Efficacy of Candesartan on Symptomatic Heart Failure in Treating Diabetic and Hypertensive Patients.

A Phase 3 study testing Candesartan in people with Heart Failure, run by Takeda at 37 sites in Germany.

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

The purpose of this study is to determine the effects of candesartan, once daily (QD), on the N-terminal pro-B-type Natriuretic Peptide laboratory marker in subjects with symptomatic heart failure with diastolic dysfunction. Read more about this study

Who is it for?
Ages 45 years and older
Conditions the study is for
Heart Failure
What is being tested?
Candesartan
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
22 participants
Where
37 sitesGermany
Study dates
Jan 2008to Dec 2008
Phase
Phase 3
Are there results?
None posted in the registry

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

Who may be able to join

  • Diabetes mellitus type 2 - insulin dependent or orally treated or managed by diet for at least 3 Months.
  • Normotension or controlled hypertension with sitting Systolic Blood Pressure less than 140 mmHg and/or sitting Diastolic Blood Pressure less than 90 mmHg.
  • Regular sinus rhythm or atrial fibrillation with a medicamental-achieved rate control of less than 100 bpm as confirmed by electrocardiogram recordings.
  • Echocardiographic evidence of a preserved Left Ventricular Ejection Fraction greater than or equal to 45% (assessed by the modified Simpson method), with further doppler-echocardiographic criteria for diastolic dysfunction grade I-IV.
  • New York Heart Association classification of II or III in a stable condition since at least 3 months.
  • Existing background heart failure therapy with an Angiotensin-Converting Enzyme Inhibitor alone or together with further preparations in a constant regimen since at least 1 month, in case of beta-blockers since at least 3 months.
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  • N-terminal pro-B-type Natriuretic Peptide greater than or equal to 250 pg/ml measured at screening visit or collected from a dated previous laboratory document not older than 3 months.
  • No previous therapy with Angiotensin-Receptor Blockers during the last 4 weeks prior to the study.
  • Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study.

Who cannot join

  • Impaired renal function (serum creatinine greater than 2.2 mg/dl or greater than 194 μmol/l).
  • Known bilateral renal artery stenosis or interventional treatment for renal artery stenosis in the last year.
  • State after kidney transplantation.
  • Serum potassium greater than 5.5 mmol/l or glycosylated hemoglobin greater than 9.5 %.
  • Cor pulmonale or primary pulmonary disease with dyspnea at rest.
  • Known disposition to episodes of symptomatic hypotension or sitting Systolic Blood Pressure less than 95 mmHg at baseline.
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  • Acute coronary syndrome or any form of unstable chronic Coronary Artery Disease where the indication of a coronary intervention is either planned in short or medium term or can not be clearly excluded for the period of the study.
  • Any history of: myocardial infarction, previous Percutaneous Transluminal Coronary Angioplasty with revascularization, stent implantation, Coronary Artery Bypass Graft or open heart surgery.
  • Tachycardia at rest greater than 100 bpm as confirmed by electrocardiogram recordings.
  • Known clinically relevant rhythm disorders (e.g., tachyarrhythmias, salves of supraventricular or ventricular extrasystoles or atrial fibrillation without ventricular rate control) or symptoms suggesting a significant rhythm disorder (e.g., recurrent syncopes).
  • Primary valvular diseases and/or restrictive or obstructive cardiomyopathy.
  • Existing ventricular assist devices.
  • Relevant liver diseases (cholestasis or alanine aminotransferase/aspartate aminotransferase greater than 2 times the upper limit of normal or gamma- glutamyltransferase greater than 3 times the upper limit of normal).
  • History of primary hyperaldosteronism, of cancer in the last 5 years or of another wasting disease with life expectancy of less than 2 years.
  • Known hypersensitivity to Candesartan Cilexetil.
  • Is required to take or intends to continue taking any disallowed medication, any prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including:
  • Need for maintenance therapy with Non-steroidal anti-inflammatory drugs or Cox-2-inhibitors.
  • Use of other Angiotensin-Receptor Blockers.
  • Any history of life-threatening diseases.
  • History of drug addiction and/or an extensive use of alcohol.
  • Acute coronary syndrome or unstable angina pectoris and any coronary artery disease that was not stable during the last 3 months prior to inclusion.
  • Patients who are dependent on a permanently paced pacemaker (i.e. a patient with a device that is not pacing during the echocardiographic examination can enter the study).
  • Open heart surgery for other reasons than coronary revascularization
  • Participation in another clinical investigation within 30 days prior to enrolment or for the course of the present study.

Trial locations and contacts

37 sites in 1 country.

37 sites in 1 country

Germany37 sites
  • Study site

    Bad Friedrichshall, Baden-Wurttemberg

  • Study site

    Bad Homburg, Hesse

  • Study site

    Bad Kreuznach, Rhineland-Palatinate

  • Study site

    Bad Nauheim, Hesse

  • Study site

    Berlin, State of Berlin

  • Study site

    Coswig, Saxony-Anhalt

  • Study site

    Darmstadt, Hesse

  • Study site

    Dresden, Saxony

  • Study site

    Erfurt, Thuringia

  • Study site

    Essen, North Rhine-Westphalia

  • Study site

    Frankfurt am Main, Hesse

  • Study site

    Gelsenkirchen, North Rhine-Westphalia

  • Study site

    Giessen, Hesse

  • Study site

    Gladbeck, North Rhine-Westphalia

  • Study site

    Hartmannsdorf, Saxony

  • Study site

    Heidelberg, Baden-Wurttemberg

  • Study site

    Jena, Thuringia

  • Study site

    Kassel, Hesse

  • Study site

    Langenfeld, North Rhine-Westphalia

  • Study site

    Leipzig, Saxony

  • Study site

    Leisnig, Saxony

  • Study site

    Limburg an der Lahn, Hesse

  • Study site

    Ludwigsburg, Baden-Wurttemberg

  • Study site

    Machem, Saxony

  • Study site

    Markkleeberg, Saxony

  • Study site

    Melsungen, Hesse

  • Study site

    Mühlheim am Main, Hesse

  • Study site

    Neukirchen, Saarland

  • Study site

    Nienburg, Lower Saxony

  • Study site

    Nordhausen, Thuringia

  • Study site

    Northeim, Lower Saxony

  • Study site

    Paderborn, North Rhine-Westphalia

  • Study site

    Riesa, Saxony

  • Study site

    Siegen, North Rhine-Westphalia

  • Study site

    Wermsdorf, Saxony

  • Study site

    Weyhe, Lower Saxony

  • Study site

    Wiesbaden, Hesse

Other trials in Germany

About this study

Official title: Candesartan "Added" Therapy for Treatment Optimization of Symptomatic Heart Failure With Diastolic Dysfunction in Diabetic and Hypertensive Patients A Randomized, Placebo-controlled, Double-blind, Parallel-group and Multicenter Clinical Phase III Study Investigating the Effects on NT-proBNP Over 6 Months

The purpose of this study is to determine the effects of candesartan, once daily (QD), on the N-terminal pro-B-type Natriuretic Peptide laboratory marker in subjects with symptomatic heart failure with diastolic dysfunction.

Read the detailed description

Heart diseases are the number one cause of death in developed countries and in particular chronic or congestive heart failure is the leading cause of hospitalization in patients older than 65 years. It is still increasing in prevalence and, in spite of significant advances in therapy, mortality rates remain high: 30% to 40% of patients with advanced disease, and 5% to 10% of patients with mild symptoms will die within 5 to 10 years.

A relevant proportion of the heart failure patients (30 - 50%) suffering from edema and dyspnea have normal or minimally impaired left ventricular ejection fraction (preserved left ventricular ejection fraction) with diastolic abnormalities in echocardiography. Features of diastolic dysfunction are the stiffness, the decreased compliance and the impaired relaxation of the left ventricle. As a result, the left ventricle has a limited filling capacity during a normal left atrial pressure.

Hypertension and/or diabetes are the most predisposing conditions whereas left ventricular hypertrophy is regarded as the linking intermediate pathological condition. Moreover, recent studies showed that patients with symptomatic heart failure and an ejection fraction greater than 40% have a poor prognosis with relatively high mortality and hospitalization rates. Thus, in hypertensive patients, diastolic dysfunction has shown to be a predictor of morbidity.

Diastolic dysfunction is also a frequent finding in type 2 diabetes without symptoms and signs of heart disease. As long as it is independent of ischemic heart disease, it is presumably due to diabetic cardiomyopathy. Once aggravated to heart failure, diastolic dysfunction often coexists with systolic dysfunction as a consequence of coronary artery disease with a limited coronary reserve.

This study will determine whether pharmacological intervention into the Renin Angiotensin Aldosterone System exerted by the Angiotensin-Receptor Blocker Candesartan on top of an Angiotensin-Converting Enzyme Inhibitor-based therapy may lead to a significant drop of N-terminal pro-B-type Natriuretic Peptide. This neurohormonal laboratory marker is sufficient enough to simultaneously indicate the improvement of the causing diastolic dysfunction and associated heart failure symptoms as assessed by objective echocardiographic and clinical parameters.

Total time for participants in this study is approximately 26 weeks.

Conditions
Heart Failure
Being tested
Candesartan, Placebo
Keywords
Cardiac Failure, Congestive Heart Failure, Drug Therapy, Hypertension, Diabetes Mellitus
Medical subject headings
Heart Failure, Hypertension, Diabetes Mellitus

What participants receive

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

  • CandesartanDrug

    Also called BLOPRESS®

    Candesartan up to 32 mg, tablets, orally, once daily and ongoing angiotensin-converting enzyme inhibitor/beta-blocker therapy for up to 24 weeks.

  • PlaceboDrug

    Candesartan matching-placebo tablets, orally, once daily and ongoing angiotensin-converting enzyme inhibitor/beta-blocker therapy for up to 24 weeks.

Study groups in NCT00775840
Study groupRoleWhat they receive
Candesartan QD + Heart Failure TherapyExperimental(with angiotensin-converting enzyme-inhibitors/beta-blockers)
Receives: Drug: Candesartan
Placebo QD + Heart Failure TherapyPlacebo comparator(with angiotensin-converting enzyme-inhibitors/beta-blockers)
Receives: Drug: Placebo

What is being measured

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

  1. The change from Baseline in N-terminal pro-B-type Natriuretic Peptide biomarker.

    Measured: Week 24 or Final Visit.

Secondary outcomes (22)
  1. Mean change in N-terminal pro-B-type Natriuretic Peptide (log-transformed).

    Measured: Weeks 6 and 24 or Final Visit.

  2. Change from Baseline in Short Form-36 Health Survey score.

    Measured: Week 24 or Final Visit.

  3. Change from Baseline in Cystatin C.

    Measured: Week 24 or Final Visit.

  4. Change from Baseline in Adiponectin.

    Measured: Week 24 or Final Visit.

  5. Change from Baseline in Glycosylated Hemoglobin.

    Measured: Week 24 or Final Visit.

  6. Change from Baseline in Urinary Albumin Excretion.

    Measured: Week 24 or Final Visit.

  7. Change from Baseline in estimated Glomerular Filtration Rate and Cystatin C.

    Measured: Week 24 or Final Visit.

  8. Mean Change in New York Heart Association classification results.

    Measured: Week 24 or Final Visit.

  9. Body Weight.

    Measured: Week 24 or Final Visit.

  10. Blood Pressure.

    Measured: Week 24 or Final Visit.

  11. Echocardiograms.

    Measured: Week 24 or Final Visit.

  12. Correlations of N-terminal pro-B-type Natriuretic Peptide with New York Heart Association Classification Results.

    Measured: Week 24 or Final Visit.

  13. Correlations of N-terminal pro-B-type Natriuretic Peptide with short Form-36 Health Survey Score.

    Measured: Week 24 or Final Visit.

  14. Correlations of N-terminal pro-B-type Natriuretic Peptide with Blood Pressure Results.

    Measured: Week 24 or Final Visit.

  15. Subgroup evaluations regarding beta-blocker therapy and New York Heart Association class (II/III).

    Measured: Week 24 or Final Visit.

  16. Subgroup evaluations in terms of the different possible dosages of study medication.

    Measured: Weeks 6 to 24 or Final Visit.

  17. Subgroup evaluations based on different baseline levels of estimated Glomerular Filtration Rate.

    Measured: Week 24 or Final Visit.

  18. Subgroup evaluations based on different baseline levels of Cystatin C.

    Measured: Week 24 or Final Visit.

  19. Subgroup evaluations based on different baseline levels of N-terminal pro-B-type Natriuretic Peptide.

    Measured: Week 24 or Final Visit.

  20. Comparison from Baseline on the concomitant use of Loop Diuretics.

    Measured: Weeks 6 and 24 or Final Visit.

  21. Transition from sinus rhythm to permanent atrial fibrillation based on electrocardiogram recordings.

    Measured: Week 24 or Final Visit.

  22. Progression of preserved (Left Ventricular Ejection Fraction greater than or equal to 45%) to impaired systolic dysfunction (Left Ventricular Ejection Fraction less than 45%), based on echocardiographic results.

    Measured: Week 24 or Final Visit.

Timeline

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

  1. First posted20 Oct 2008 (estimated)
  2. Study startJan 2008
  3. Primary completionDec 2008
  4. Study completionDec 2008

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
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
22 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00775840
Sponsor's protocol ID
BLO K026
Other IDs
2007-003070-26, D-CAN-546, U1111-1113-9515
Status last verified
Jun 2010
First submitted
16 Oct 2008
Last updated
22 Jun 2010
Results posted
No
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Candesartan in people with Heart Failure, run by Takeda at 37 sites in Germany.

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 9 inclusion and 24 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 22 Jun 2010. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 37 sites in Germany. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

The change from Baseline in N-terminal pro-B-type Natriuretic Peptide biomarker. (time frame: Week 24 or Final Visit.). 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 22 Jun 2010.

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