Status:
COMPLETED
Effects of Aliskiren, Irbesartan, and the Combination in Hypertensive Patients With Type 2 Diabetes and Diabetic Nephropathy
Lead Sponsor:
Novartis
Conditions:
Diabetes Type 2
Eligibility:
All Genders
30-80 years
Phase:
PHASE1
PHASE2
Brief Summary
This study will assess the reno-protective effect of renin inhibition with aliskiren as an alternative to irbesartan in type 2 diabetes patients with incipient/overt diabetic nephropathy.
Detailed Description
Antiproteinuric Effects of Aliskiren (Renin Inhibitor), Irbesartan (Angiotensin Receptor Antagonist) and the Combination in Hypertensive Patients With Type 2 Diabetes and Incipient/Overt Diabetic Neph...
Eligibility Criteria
Inclusion
- Male and/or female subjects between the ages of 30-80 years with a diagnosis of type 2 diabetes (World Health Organization criteria)
- Body mass index (BMI) within the range of 20 and 32.
- Incipient or overt diabetic nephropathy (urinary albumin excretion ≥ 100 but ≤ 2000 mg/day).
- Glomerular filtration rate (GFR) ≥ 40 ml/min documented in the last 4 months prior to randomization
- To be eligible for randomization, patients must fulfill the following criteria:
- Patients on ongoing hypertensive therapy must have a blood pressure ≥ 135/85 mmHg but lower than 170/105 mmHg at Visit 2 (Day -1) AND patients must be on stable antihypertensive medications for at least 8 weeks prior to Visit 2 (run-in period).
- Newly diagnosed hypertensive patients must have a blood pressure ≥ 135/85 mmHg but lower than 170/105 mmHg at Visit 2 (Day -1).
- Patients must be on stable hypoglycemic medications for at least 8 weeks prior to Visit 2 (Day -1).
- Patients must be willing and medically able to discontinue all angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), aldosterone receptor antagonist and potassium sparing diuretic medications for the duration of the study.
- Female patients must be postmenopausal, have had a bilateral oophorectomy, or have been surgically sterilized or hysterectomized at least 6 months prior to screening.
- Oral body temperature within the range of 35.0-37.5 °C
- Able to provide written informed consent prior to study participation.
- Able to communicate well with the investigator and comply with the requirements of the study.
Exclusion
- Severe hypertension, Grade 3 World Health Organization (WHO) classification (mean sitting diastolic blood pressure \[MSDBP\] ≥ 110 mmHg and/or mean sitting systolic blood pressure \[MSSBP\] ≤ 180 mmHg)
- Acetylsalicylic acid (ASA) treatment \> 1 g/day or regular use of nonsteroidal anti-inflammatory drugs (NSAIDs)
- Kidney disease not caused by diabetes or hypertension
- Serum potassium \< 3.5 or \> 5.1 mEq/L
- GFR \< 40 ml/min/1.73m2 as measured by the Modification of Diet in Renal Disease (MDRD) formula
- Serum albumin \< 2.0 mg/dL
- History of hypertensive encephalopathy or cerebrovascular accident in the last 12 months prior to Visit 1
- Transient ischemic cerebral attack during the 6 months prior to Visit 1
- Current diagnosis of heart failure (New York Heart Association \[NYHA\] Class II-IV)
- History of myocardial infarction, unstable angina pectoris, coronary bypass surgery, or any percutaneous coronary intervention (PCI) during the 6 months prior to Visit 1
- Second or third degree heart block without a pacemaker
- Concurrent potentially life threatening arrhythmia or symptomatic arrhythmia
- Clinically significant valvular heart disease
- Type 1 diabetes mellitus
- Uncontrolled type II diabetes mellitus; hemoglobin subtype A1C (HbA1C) \> 11%
- History of malignancy including leukemia and lymphoma (but not basal cell skin carcinoma) within the past five years
- Participation in any clinical investigation within 4 weeks prior to dosing or longer if required by local regulation.
- Donation or loss of 400 mL or more of blood within 8 weeks prior to dosing.
- Significant illness within the two weeks prior to dosing.
- Any surgical or medical condition which might significantly alter the absorption, distribution, metabolism, or excretion of study drugs including, but not limited to, any of the following:
- History of major gastrointestinal tract surgery such as gastrectomy, gastroenterostomy, or bowel resection
- Currently active or previously active inflammatory bowel disease during the 12 months prior to Visit 1
- Currently active gastritis, duodenal or gastric ulcers, or gastrointestinal/rectal bleeding during the 3 months prior to Visit 1.
- Any history of pancreatic injury, pancreatitis or evidence of impaired pancreatic function/injury as indicated by abnormal lipase or amylase
- Evidence of hepatic disease, a history of hepatic encephalopathy, a history of esophageal varices, or a history of portacaval shunt
- Current treatment with cholestyramine or colestipol resins
- History of immunocompromise, including a positive test result.
- History of a positive hepatitis B surface antigen (HBsAg) or hepatitis C test result.
- History of drug or alcohol abuse within the 12 months prior to dosing.
- Persons directly involved in the execution of this protocol.
- Any condition that, in the opinion of the investigator or the Novartis medical monitor, would jeopardize the evaluation of efficacy or safety
- History of noncompliance to medical regimens or unwillingness to comply with the study protocol
- Known or suspected contraindications to the study medications, including history of allergy to ACE inhibitors and/or to thiazide diuretics or other sulfonamide derived drug
- Any surgical or medical condition, which in the opinion of the investigator, may place the patient at higher risk from his/her participation in the study, or is likely to prevent the patient from complying with the requirements of the study or completing the study
- Use of any prescription drug or over-the-counter (OTC) medication which is prohibited by the protocol.
- Patients who previously participated in any aliskiren study.
- Other protocol-defined inclusion/exclusion criteria may apply.
Key Trial Info
Start Date :
September 1 2005
Trial Type :
INTERVENTIONAL
End Date :
November 1 2007
Estimated Enrollment :
24 Patients enrolled
Trial Details
Trial ID
NCT00464880
Start Date
September 1 2005
End Date
November 1 2007
Last Update
November 29 2007
Active Locations (1)
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1
Novartis
Gentofte Municipality, Denmark, 2820