A Phase 4 interventional study of telmisartan combined with hydrochlorothiazide (80/12.5 mg) and valsartan combined with hydrochlorothiazide (160/12.5mg) in Hypertension and Diabetes Mellitus, Type 2, sponsored by Boehringer Ingelheim. Completed at 102 sites in 8 countries. Open to participants aged 30 Years and older. Per ClinicalTrials.gov, last updated 2013-11-08.
Sponsored by Boehringer Ingelheim · Phase 4, Interventional, and Treatment
The primary objective of this study is to demonstrate that telmisartan 80 mg combined with hydrochlorothiazide 12.5 mg (T80/H12.5) is at least as effective and possibly superior to valsartan 160 mg combined with hydrochlorothiazide 12.5 mg (V160/H12.5) in lowering mean ambulatory systolic blood pressure (SBP) and diastolic blood pressure (DBP) during the last 6 hours of the 24-hour dosing interval at the end of a 10-week treatment period in mild-to-moderate hypertensive, overweight or obese patients with type 2 diabetes mellitus
Methodology:
Prospective, randomised, open-label, blinded end-point, forced-titration, parallel group comparison using Ambulatory Blood Pressure Monitoring (ABPM).
Planned/Actual Number of Subjects:
Enrolled: 1500/2085; Randomised: 750/840; Complete: 680/752
Diagnosis and Main Criteria for Inclusion:
Duration of Treatment:
10 weeks total: telmisartan (80 mg) or valsartan (160 mg) for 4 weeks followed by telmisartan (80 mg) plus hydrochlorothiazide (12.5 mg) or valsartan (160 mg) plus hydrochlorothiazide (12.5 mg) for an additional 6 weeks.
Criteria for Efficacy:
Primary Endpoint:
Reductions in blood pressure during the last 6 hours of the 24-hour dosing interval as measured by ABPM. The primary analysis will consist of comparing telmisartan combined with hydrochlorothiazide 80 mg/12.5 mg to valsartan combined with hydrochlorothiazide 160 mg/12.5 mg at the end of the 10-week study using a closed testing procedure first testing for non-inferiority based on SBP; if significant, testing for non-inferiority based on DBP; if significant, testing for superiority based on SBP; and if significant, testing for superiority based on DBP.
Secondary Endpoints:
Statistically greater reductions in ambulatory blood pressure for patients treated with telmisartan combined with hydrochlorothiazide 80 mg/12.5 mg compared to patients treated with valsartan combined with hydrochlorothiazide 160 mg/12.5 mg at the end of the 10-week study as measured by: 1) Changes from baseline in the last 6 hours of the 24-hour dosing interval for pulse pressure; 2) Changes from baseline in the 24-hour ABPM mean (relative to dose time) for SBP, DBP, and pulse pressure; 3) Changes from baseline in the ABPM mean SBP, DBP, and pulse pressure (relative to clock time) during other periods (i.e., morning, daytime, night time) of the 24-hour dosing interval; 4) Change from baseline in systolic and diastolic blood pressure load during the 24-hour dosing interval; and 5) Percentage of patients responding to treatment based on the 24-hour ABPM mean SBP and DBP (relative to dose time).
Statistically greater reduction in mean seated trough blood pressure patients treated with telmisartan combined with hydrochlorothiazide 80 mg/12.5 mg compared to patients treated with valsartan combined with hydrochlorothiazide 160 mg/12.5 mg at the end of the 10-week study as measured by: 1) Changes from baseline in mean seated trough SBP and DBP as determined by electronic or manual device in-clinic; and 2) Percentage of patients responding to treatment based on electronic or manual in-clinic trough cuff blood pressures.
Evaluation of other endpoints comparing telmisartan combined with hydrochlorothiazide 80 mg/12.5 mg to valsartan combined with hydrochlorothiazide 160 mg/12.5 mg, respectively, including: 1) Changes from baseline in metabolic markers: serum TG, LDL-C, HDL-C, total cholesterol, potassium, fasting glucose and HbA1C, and for urine: Na, K, Cl, proteinuria (as measured by spot urine for protein:creatinine ratio); and 2) inflammatory markers: serum high sensitive C-reactive protein, serum homocysteine and plasma fibrinogen.
Criteria for Safety:
Evaluation of adverse events, physical examinations, laboratory assessments, pulse rate and cuff blood pressure monitoring.
Statistical Method:
Analysis of covariance with treatment and centre as main effects and baseline as a covariate; Mantel-Haenszel test controlling for centre.
Study Hypothesis:
Null Hypothesis:
The overall mean change from baseline in the automated blood pressure monitor mean blood pressure during the last 6 hours of the 24-hour dosing interval for telmisartan (80 mg) plus hydrochlorothiazide (12.5 mg) is less than or equal to that for valsartan (160 mg) plus hydrochlorothiazide (12.5 mg).
Alternative Hypothesis:
The overall mean change from baseline in the automated blood pressure monitor mean blood pressure during the last 6 hours of the 24-hour dosing interval for telmisartan (80 mg) plus hydrochlorothiazide (12.5 mg) is greater than that for valsartan (160 mg) plus hydrochlorothiazide (12.5 mg).
Comparison(s):
Telmisartan (80 mg) plus hydrochlorothiazide (12.5 mg) vs. valsartan (160 mg) plus hydrochlorothiazide (12.5 mg)
6,689 studies on the registry are indexed under Hypertension; 965 are open to participants now.
This study's enrollment of 840 is above the median of 90 across 4,995 interventional studies indexed under Hypertension.
Browse Hypertension studies →Boehringer Ingelheim is the lead sponsor of 2,245 studies on the registry; 58 are open to participants now.
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Exclusion Criteria:
Changes from baseline in the mean SBP and DBP as measured by ambulatory blood pressure monitoring (ABPM)
Time frame: 10 weeks
Changes from baseline in the last 6-hour ABPM mean (relative to dose time) pulse pressure.
Time frame: 10 weeks
Changes from baseline in the 24-hour ABPM mean (relative to dose time) for SBP, DBP and pulse pressure.
Time frame: 10 weeks
Changes from baseline in the ABPM mean (relative to clock time) for SBP, DBP, and pulse pressure during the morning, daytime and night time periods of the 24-hour dosing interval.
Time frame: 10 weeks
Changes from baseline in SBP and DBP load during the 24-hour dosing interval.
Time frame: 10 weeks
Responder rates based on the 24-hour ABPM mean (relative to dose time) blood pressures defined
Time frame: 10 weeks
In-clinic trough cuff blood pressure measures at the end of both a 4-week (Visit 4) treatment period and a 10-week (Visit 6) treatment period.
Time frame: 4 weeks and 10 weeks
Responder rates based on the mean seated trough cuff measurements
Time frame: 4 weeks and 10 weeks
Metabolic and inflammatory marker changes from baseline
Time frame: up to 10 weeks
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Boehringer Ingelheim