CClinicalTrials.gg
CompletedNCT00996281Updated Nov 12, 2012Results posted

Safety and Tolerability of Azilsartan Medoxomil Plus Chlorthalidone Compared to Olmesartan Medoxomil Plus Hydrochlorothiazide in Participants With Essential Hypertension

A Phase 3 interventional study of Azilsartan medoxomil and chlorthalidone and Olmesartan medoxomil and hydrochlorothiazide in Essential Hypertension, sponsored by Takeda. Completed at 26 sites in 5 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2012-11-12.

Sponsored by Takeda · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
837
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to compare the safety and tolerability of azilsartan medoxomil plus chlorthalidone, once daily (QD), versus olmesartan medoxomil-hydrochlorothiazide in adults with essential hypertension.

Read the detailed description

High Blood Pressure (Hypertension) is the most common cause of preventable death in developed nations. Uncontrolled hypertension greatly increases the risk of heart disease, brain disease, and kidney failure. As the population ages, the incidence of hypertension will continue to increase if effective preventive measures are not implemented. Despite the availability of antihypertensive agents, hypertension is not adequately controlled; only about one in three patients successfully keep blood pressure normal.

Treatment for high blood pressure includes thiazides or thiazide-like diuretics, either alone or as part of combination treatment. Chlorthalidone is a commercially available, orally administered thiazide-type diuretic agent.

TAK-491 (azilsartan) is an angiotensin II receptor blocker being evaluated by Takeda to treat patients with high blood pressure (essential hypertension).

This study will compare the safety and tolerability of azilsartan medoxomil plus chlorthalidone (TAK-491CLD) fixed-dose combination to olmesartan medoxomil-hydrochlorothiazide fixed-dose combination.

Initially patients will undergo a Screening Visit to confirm that they are eligible to participate in the study. All participants will receive the study drug for up to 52 weeks. The dose of the study drug may be gradually increased throughout the study so that a target blood pressure value can be reached for each participant.

Throughout the treatment period of the study, participants will be required to visit the research site for 11 visits. At these study visits participants will be required to undergo certain study procedures including physical examinations, vital sign measurements (blood pressure, heart rate, weight and height), electrocardiograms (monitoring of the heart), and blood and urine samples taken for clinical laboratory tests.

02

Conditions studied

  • Essential Hypertension

Keywords

  • Hypertensive
  • Blood Pressure, High
  • Cardiovascular disease
  • Vascular Disease
  • Drug Therapy
03

In context

Hypertension

6,689 studies on the registry are indexed under Hypertension; 965 are open to participants now.

This study's enrollment of 837 is above the median of 90 across 4,995 interventional studies indexed under Hypertension.

Browse Hypertension studies →

Lead sponsor

Takeda is the lead sponsor of 1,002 studies on the registry; 92 are open to participants now.

Of its 173 completed or terminated interventional studies of FDA-regulated products, 149 (86%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Is treated with antihypertensive therapy and has a post-washout mean sitting clinic systolic blood pressure greater than or equal to 160 and less than or equal to 190 mm Hg on Day, or has not received antihypertensive treatment within 14 days prior to Screening and has a mean sitting clinic systolic blood pressure greater than or equal to 160 and less than or equal to 190 mm Hg at the Screening Visit and on Day 1.
  • Females of childbearing potential who are sexually active agree to routinely use adequate contraception, and can neither be pregnant nor lactating from before study participation to Screening to 30 days after the last study drug dose.
  • Has clinical laboratory test results within the reference range for the testing laboratory or the investigator does not consider the results to be clinically significant.
  • Is willing to discontinue current antihypertensive medications up to 3 weeks before enrollment.

Exclusion criteria

Exclusion Criteria:

  • Has a mean clinic diastolic blood pressure (sitting, trough) greater than 119 mm Hg on Day 1.
  • Has secondary hypertension of any etiology (eg, renovascular disease, pheochromocytoma, Cushing's syndrome).
  • Has a recent history (within the last 6 months) of myocardial infarction, heart failure, unstable angina, coronary artery bypass graft, percutaneous coronary intervention, hypertensive encephalopathy, cerebrovascular accident or transient ischemic attack.
  • Has clinically significant cardiac conduction defects (ie, third-degree atrioventricular block, sick sinus syndrome).
  • Has hemodynamically significant left ventricular outflow obstruction due to aortic valvular disease.
  • Has severe renal dysfunction or disease.
  • Has known or suspected unilateral or bilateral renal artery stenosis.
  • Has a history of cancer that has not been in remission for at least 5 years prior to the first dose of study drug.
  • Has poorly-controlled type 1 or 2 diabetes mellitus at Screening.
  • Has hypokalemia or hyperkalemia at Screening.
  • Has an alanine aminotransferase or aspartate aminotransferase level of greater than 2.5 times the upper limit of normal, active liver disease, or jaundice at Screening.
  • Has any other known serious disease or condition that would compromise safety, might affect life expectancy, or make it difficult to successfully manage and follow according to the protocol.
  • Has known hypersensitivity to angiotensin II receptor blockers or thiazide-type diuretics or other sulfonamide-derived compounds.
  • Has been randomized/enrolled in a previous azilsartan or azilsartan medoxomil plus chlorthalidone study.
  • Currently is participating in another investigational study or has received any investigational compound within 30 days prior to Screening.
  • Has a history of drug abuse or a history of alcohol abuse within the past 2 years.
  • Is taking or expected to take any excluded medication, including:

    • Antihypertensive medications must be discontinued completely by Day -14, except antihypertensive medications used in the open-label treatment period in accordance with the titration-to-target blood pressure titration.
    • Angiotensin II receptor blockers or thiazide-type diuretics other than study medication.
    • Over-the-counter products not permitted by investigator.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
837 participants (actual)

Study arms

  • Experimental
    Azilsartan Medoxomil and Chlorthalidone

    Azilsartan medoxomil 40 mg and chlorthalidone 12.5 mg combination tablet, orally, once daily for up to 52 weeks. For participants who did not achieve target blood pressure by Week 4, titration to a maximum dose of azilsartan medoxomil 80 mg and chlorthalidone 25 mg.

    Drug: Azilsartan medoxomil and chlorthalidone

  • Active comparator
    Olmesartan Medoxomil and Hydrochlorothiazide QD

    Participants in the United States: Olmesartan medoxomil 20 mg and hydrochlorothiazide 12.5 mg combination tablet, orally, once daily for up to 52 weeks. For participants who did not achieve target blood pressure by Week 4, titration to a maximum dose of Olmesartan medoxomil 40 mg and hydrochlorothiazide 25 mg. Participants in Europe: Olmesartan medoxomil 20 mg and hydrochlorothiazide 12.5 mg combination tablet, orally, once daily for up to 52 weeks. For participants who did not achieve target blood pressure by Week 4, titration to a maximum dose of Olmesartan medoxomil 20 mg and hydrochlorothiazide 25 mg.

    Drug: Olmesartan medoxomil and hydrochlorothiazide

Interventions

  • DrugAzilsartan medoxomil and chlorthalidone

    Combination tablet.

    Also known as: TAK-491CLD

  • DrugOlmesartan medoxomil and hydrochlorothiazide

    Combination tablet.

    Also known as: Benicar HCT®, Olmetec Plus®

06

What researchers measure

Primary outcomes

  1. Percentage of Participants With at Least 1 Adverse Event

    An adverse event is defined as any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product without regard to causality.

    Time frame: From Week 0 (Day 1) to Week 52.

Secondary outcomes

  1. Percentage of Participants With Serum Creatinine Elevations Greater Than 50% From Baseline and Greater Than the Upper Limit of Normal (ULN)

    Serum creatinine was measured at every visit and evaluated as a laboratory parameter of special interest. The percentage of participants with creatinine increase ≥50% from Baseline and greater than ULN was summarized: - At any visit (includes transient and persistent elevations). - At the Final Visit (includes persistent elevations and participants whose first elevation may have been at the Final Visit). - At least 2 consecutive visits (includes only persistent elevations).

    Time frame: Baseline and Week 52

07

Results

Posted Nov 12, 2012

Participant flow

Participants took part in the study at 79 investigative sites in the United States, Netherlands, Poland, the United Kingdom and Germany from 27 October 2009 to 17 November 2011.

Participant flow — Overall Study
MilestoneAzilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and Hydrochlorothiazide
Started418419
Completed287330
Not completed13189
Withdrew: Adverse event7537
Withdrew: Major protocol deviation67
Withdrew: Lost to follow-up1416
Withdrew: Withdrawal by subject3120
Withdrew: Lack of efficacy02
Withdrew: Other57

Outcome measures

PrimaryPercentage of Participants With at Least 1 Adverse Event

An adverse event is defined as any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product without regard to causality.

Time frame:
From Week 0 (Day 1) to Week 52.
Reported as:
Number · percentage of participants
Percentage of Participants With at Least 1 Adverse Event
percentage of participantsAzilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and Hydrochlorothiazide
Percentage of Participants With at Least 1 Adverse Event78.576.4
SecondaryPercentage of Participants With Serum Creatinine Elevations Greater Than 50% From Baseline and Greater Than the Upper Limit of Normal (ULN)

Serum creatinine was measured at every visit and evaluated as a laboratory parameter of special interest. The percentage of participants with creatinine increase ≥50% from Baseline and greater than ULN was summarized: - At any visit (includes transient and persistent elevations). - At the Final Visit (includes persistent elevations and participants whose first elevation may have been at the Final Visit). - At least 2 consecutive visits (includes only persistent elevations).

Time frame:
Baseline and Week 52
Reported as:
Number · percentage of participants
Percentage of Participants With Serum Creatinine Elevations Greater Than 50% From Baseline and Greater Than the Upper Limit of Normal (ULN)
percentage of participantsAzilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and Hydrochlorothiazide
At any postbaseline visit14.25.8
at the Final Visit5.91.0
≥2 consecutive elevations5.11.2

Adverse events

Collected over Treatment-emergent adverse events are adverse events that started after the first dose of double-blind study drug and no more than 14 days (or 30 days for a serious adverse event) after the last dose of study drug.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Azilsartan Medoxomil and Chlorthalidone—24/418 (5.7%)217/418 (51.9%)
Olmesartan Medoxomil and Hydrochlorothiazide—26/419 (6.2%)183/419 (43.7%)
Most frequent serious events
Showing 10 of 71
Most frequent serious events
EventAzilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and Hydrochlorothiazide
Septic shockInfections and infestations2/4180/419
Intervertebral disc protrusionMusculoskeletal and connective tissue disorders2/4180/419
SyncopeNervous system disorders2/4180/419
Pulmonary embolismRespiratory, thoracic and mediastinal disorders2/4180/419
Angina pectorisCardiac disorders0/4182/419
Non-cardiac chest painGeneral disorders1/4182/419
PneumoniaInfections and infestations0/4182/419
Road traffic accidentInjury, poisoning and procedural complications1/4182/419
Blood creatinine increasedInvestigations0/4182/419
Atrial fibrillationCardiac disorders1/4181/419
Most frequent other events
Most frequent other events
EventAzilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and Hydrochlorothiazide
Blood creatinine increasedInvestigations90/41835/419
DizzinessNervous system disorders68/41853/419
NasopharyngitisInfections and infestations51/41848/419
HeadacheNervous system disorders31/41846/419
Upper respiratory tract infectionInfections and infestations20/41827/419
FatigueGeneral disorders21/41817/419
DiarrhoeaGastrointestinal disorders20/41821/419
NauseaGastrointestinal disorders20/41821/419

Baseline characteristics

Age Continuous
Age Continuous(years)Azilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and HydrochlorothiazideTotal
Mean58.5 ± 10.7957.6 ± 10.8058.1 ± 10.80
Age, Customized
Age, Customized(participants)Azilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and HydrochlorothiazideTotal
<45 years464894
45 to 64 years251259510
65 to 74 years9493187
≥75 years271946
Sex: Female, Male
Sex: Female, Male(Participants)Azilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and HydrochlorothiazideTotal
Female192173365
Male226246472
Race/Ethnicity, Customized
Race/Ethnicity, Customized(participants)Azilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and HydrochlorothiazideTotal
Hispanic or Latino404181
Non-Hispanic or Latino209205414
Not collected169172341
Missing011
Race/Ethnicity, Customized
Race/Ethnicity, Customized(participants)Azilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and HydrochlorothiazideTotal
American Indian or Alaska Native459
Asian4711
Black or African American7274146
Native Hawaiian or Other Pacific Islander000
White341336677
Multiracial336
Region of Enrollment
Region of Enrollment(participants)Azilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and HydrochlorothiazideTotal
Poland5254106
United States249247496
Netherlands5658114
Germany222143
United Kingdom393978
Height
Height(cm)Azilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and HydrochlorothiazideTotal
Mean169.9 ± 10.2169.6 ± 10.1169.8 ± 10.1
Weight
Weight(kg)Azilsartan Medoxomil and ChlorthalidoneOlmesartan Medoxomil and HydrochlorothiazideTotal
Mean91.00 ± 21.02592.00 ± 21.72791.50 ± 21.373

7 further baseline measures are reported on the registry.

08

Study locations

26 sites
  • Graz, Styria, Austria
  • Karlsruhe, Baden-Wurttemberg, Germany
  • Hannover, Lower Saxony, Germany
  • Kiel-Kronshagen, Schleswig-Holstein, Germany
  • Breda, North Brabant, Netherlands
  • Eindhoven, North Brabant, Netherlands
  • Amsterdam, North Holland, Netherlands
  • Velp, Rheden, Netherlands
  • Leiderdorp, South Holland, Netherlands
  • Zoetermeer, South Holland, Netherlands
  • Rotterdam, Zuid-Holland, Netherlands
  • Groningen, Netherlands
  • Bydgoszcz, Kuyavian-Pomeranian, Poland
  • Skierniewice, L0dz, Poland
  • Zgierz, L0dz, Poland
  • Gdansk, Pomeranian, Poland
  • Gdynia, Pomeranian, Poland
  • Sopot, Pomeranian, Poland
  • Mikolow, Silesian, Poland
  • Avon, England, United Kingdom
  • Bolton, England, United Kingdom
  • Chorley, England, United Kingdom
  • Inverness, England, United Kingdom
  • Liverpool, England, United Kingdom
  • Surrey, England, United Kingdom
  • Warwickshire, England, United Kingdom
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 12, 2012, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00996281
Lead sponsor
Takeda
Responsible party
Sponsor
First posted
Oct 16, 2009
Start date
Oct 2009
Primary completion
Nov 2011
Completion
Nov 2011
Results posted
Nov 12, 2012
Last update
Nov 12, 2012

Study contacts

Executive Medical Director, Clinical Science
study director · Takeda

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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