Safety and Efficacy of Azilsartan Medoxomil in Participants With Mild to Moderate Hypertension

Condition(s) targeted: Hypertension

Intervention: Azilsartan Medoxomil (Drug); Azilsartan Medoxomil (Drug); Azilsartan Medoxomil (Drug); Azilsartan Medoxomil (Drug); Azilsartan Medoxomil (Drug); Olmesartan (Drug); Placebo (Drug)

Phase: Phase 2

Status: Completed

Sponsored by: Takeda

Official(s) and/or principal investigator(s):
VP Clinical Science Strategy, Study Director, Affiliation: Takeda

The purpose of this study is to evaluate the safety, efficacy, and tolerability of azilsartan medoxomil, once daily (QD), in individuals with hypertension.

Official title: A Phase 2, Double-Blind, Randomized, Placebo-Controlled Dose-Ranging Study of the Efficacy, Safety and Tolerability of TAK-491 in Subjects With Mild to Moderate Uncomplicated Essential Hypertension

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Primary outcome: Change From Baseline in Sitting Clinic Diastolic Blood Pressure.

Secondary outcome:

Change From Baseline in Sitting Clinic Systolic Blood Pressure.

Change From Baseline in Standing Clinic Systolic Blood Pressure.

Change From Baseline in Standing Clinic Diastolic Blood Pressure.

Change From Baseline in 24-hour Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in 24-hour Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the 12-hour Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the 12-hour Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the 10-12-hour Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the 10-12-hour Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the Trough (22-24-hr) Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the Trough (22-24-hr) Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in Daytime (6am to 10 pm) Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in Daytime (6am to 10 pm) Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the Nighttime (12 am to 6 am) Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the Nighttime (12 am to 6 am) Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the 24-36-Hour Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the 24-36-Hour Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the 34-36-Hour Mean Systolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Change From Baseline in the 34-36-Hour Mean Diastolic Blood Pressure Measured by Ambulatory Blood Pressure Monitoring.

Detailed description: Hypertension affects approximately 50 million individuals in the United States. As the population ages, the prevalence of hypertension will continue to increase if broad and effective preventive measures are not implemented. Data from the Framingham Heart study suggest that the lifetime risk of developing hypertension among 55- to 65-year-old individuals is greater than 90%. According to the World Health Organization, hypertension is the most common attributable cause of preventable death in developed nations, as uncontrolled hypertension greatly increases the risk of cardiovascular disease, cerebrovascular disease, and renal failure. Despite the availability of hypertension treatments, hypertension remains inadequately controlled; only about one third of patients continue to maintain control successfully. To help address these matters, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure proposes a more aggressive intervention to hypertension management with more potent antihypertensive agents and combination therapy. Takeda Global Research & Development Center, Inc. is developing TAK-491 (azilsartan medoxomil) to treat mild to moderate essential hypertension. Azilsartan medoxomil is a prodrug that is rapidly hydrolyzed to the activity moiety, azilsartan, which is an angiotensin II type 1 receptor antagonist. This study is proposed to evaluate the efficacy, safety and tolerability of multiple doses of azilsartan medoxomil at five dose levels in subjects with mild to moderate uncomplicated essential hypertension. Individuals who want to participate in this study will be required to provide written informed consent. Study participation is anticipated to be about 11 weeks. Multiple procedures will occur at each visit which may include fasting, blood collection, urine collection, vital signs including sitting and standing blood pressure and pulse, body height and weight, physical examinations, electrocardiogram Outside of the study center, participants will be required to wear an ambulatory blood pressure monitoring device at approximately 24 and 36 hour intervals.

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria 1. Mild to moderate uncomplicated essential hypertension. 2. 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. 3. Must be in good health as determined by a physician. 4. The subject has clinical laboratory evaluations within the reference range for the testing laboratory unless the results are deemed not clinically significant by the investigator or sponsor. 5. The subject is willing to discontinue current antihypertensive medications at Screening Day minus 21. Exclusion Criteria 1. Diastolic blood pressure less than 95 or greater than 114 mmHg at Placebo Run-in Day minus 14 or Randomization visit, or systolic blood pressure greater than 180 mm Hg. 2. Decrease of more than or equal to 8 mm Hg in clinic diastolic blood pressure between Placebo Run-in Day minus 14 and Randomization visit. 3. Has taken within 7 days prior to placebo run-in, or is expected to take medications known to affect blood pressure and is required to take or continues taking any disallowed medication, prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including: 4. Hypersensitive to angiotensin II receptor blockers. 5. History of an acute myocardial infarction within 12 months prior to Screening, history of coronary revascularization within 6 months prior to Screening, or any history of heart failure, post-myocardial infarction angina, hypertensive encephalopathy, cerebrovascular accident, or transient ischemic attack. 6. Clinically significant cardiac conduction defects (eg, 3rd degree atrioventricular block, left bundle branch block, atrial fibrillation or flutter). 7. Secondary hypertension of any etiology. 8. Upper arm circumference less than 24 or greater than 42 cm. 9. Works night (3rd) shift (defined as 11pm to 7am). 10. Non-compliant (less than 80%) with study medication during Placebo Run-in period. 11. Significant, moderate to severe renal dysfunction (confirmed by serum creatinine of greater than 2 mg per dl or disease (including renal artery stenosis or known nephrotic proteinuria). 12. History of drug abuse (defined as illicit drug use) or a history of alcohol abuse (defined as regular or daily consumption of more than 4 alcoholic drinks per day) within the past 2 years. 13. Previous history of cancer that has not been in remission for at least 5 years prior to the first dose of study drug. (This criterion does not include those subjects with basal cell or Stage 1 squamous cell carcinoma of the skin). 14. Type 1 or uncontrolled type 2 diabetes mellitus (confirmed by glycosylated hemoglobin greater than 9. 5%). 15. Alanine transaminase level of greater than 2. 5 times the upper limit of normal, active liver disease, or jaundice. 16. Currently is participating in another investigational study or has participated in an investigational study within 30 days prior to randomization. 17. Any other serious disease or condition at Screening (or randomization) that would compromise subject safety, might affect life expectancy, or make it difficult to successfully manage and follow the subject according to the protocol.

BA, Argentina

Cordoba, Argentina

Ushuaia, Argentina

Guadalajara, Jal, Mexico

Mexico, D.F., Mexico

Monterrey Nuevo Leon, Mexico

Morelia, Michoacan, Mexico

Lima, Peru

Huntsville, Alabama, United States

Ozark, Alabama, United States

Mesa, Arizona, United States

Little Rock, Arkansas, United States

Carmichael, California, United States

Long Beach, California, United States

San Diego, California, United States

Tustin, California, United States

Denver, Colorado, United States

Stamford, Connecticut, United States

Trumbull, Connecticut, United States

Waterbury, Connecticut, United States

Hollywood, Florida, United States

Jacksonville, Florida, United States

Melbourne, Florida, United States

Miami, Florida, United States

Pembroke Pines, Florida, United States

Pinellas Park, Florida, United States

Atlanta, Georgia, United States

Evansville, Indiana, United States

Shawnee Mission, Kansas, United States

Auburn, Maine, United States

Trenton, New Jersey, United States

Binghamtom, New York, United States

Rochester, New York, United States

Burlington, North Carolina, United States

Charlotte, North Carolina, United States

Concord, North Carolina, United States

Hickory, North Carolina, United States

Salisbury, North Carolina, United States

Winston-Salem, North Carolina, United States

Cincinnati, Ohio, United States

Columbus, Ohio, United States

Oklahoma, Oklahoma, United States

Anderson, South Carolina, United States

Mt. Pleasant, South Carolina, United States

Simpsonville, South Carolina, United States

Bristol, Tennessee, United States

Austin, Texas, United States

Dallas, Texas, United States

Euless, Texas, United States

North Richland Hills, Texas, United States

San Antonio, Texas, United States

Lakewood, Washington, United States

Renton, Washington, United States

Madison, Wisconsin, United States

EDARBI Package Insert

Starting date: May 2006
Last updated: March 24, 2011