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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT00549757
Other study ID # CSPP100E2337
Secondary ID 2007-000860-25
Status Terminated
Phase Phase 3
First received October 24, 2007
Last updated April 1, 2014
Start date October 2007
Est. completion date February 2013

Study information

Verified date April 2014
Source Novartis
Contact n/a
Is FDA regulated No
Health authority United States: Food and Drug AdministrationArgentina: Administracion Nacional de Medicamentos, Alimentos y Tecnologia MedicaAustria: Federal Office for Safety in Health CareBelgium: Federal Agency for Medicinal Products and Health ProductsBrazil: Ministry of HealthCanada: Health CanadaChina: Food and Drug AdministrationColombia: INVIMA Instituto Nacional de Vigilancia de Medicamentos y AlimentosCzech Republic: State Institute for Drug ControlDenmark: Danish Medicines AgencyFinland: Finnish Medicines AgencyFrance: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)Germany: Federal Institute for Drugs and Medical DevicesGreece: National Organization of MedicinesGuatemala: Ministry of Public Health and Social AssistanceHungary: National Institute of PharmacyIndia: Central Drugs Standard Control OrganizationItaly: National Institute of HealthJapan: Pharmaceuticals and Medical Devices AgencyKorea: Food and Drug AdministrationLithuania: State Medicine Control Agency - Ministry of HealthNetherlands: Medicines Evaluation Board (MEB)Norway: Norwegian Medicines AgencyPeru: General Directorate of Pharmaceuticals, Devices, and DrugsPortugal: National Pharmacy and Medicines InstituteSingapore: Center for Drug AdministrationSlovakia: State Institute for Drug ControlSouth Africa: Medicines Control CouncilSpain: Spanish Agency of MedicinesSweden: Medical Products AgencySwitzerland: SwissmedicTaiwan: Department of HealthThailand: Ministry of Public HealthTurkey: General Directorate of Pharmaceuticals and PharmacyUnited Kingdom: Medicines and Healthcare Products Regulatory AgencyVenezuela: Ministry of Health and Social Development
Study type Interventional

Clinical Trial Summary

The purpose of this study was to determine whether, in patients with type 2 diabetes and pre-existing disease of the heart and the circulatory system and/or the kidney, aliskiren at a target dose of 300 mg once daily (compared to placebo), on top of conventional treatment, reduces death and disease caused by the heart, the circulatory system and the kidney.

AMENDMENT 4 RATIONALE (MARCH 2012) :

Protocol amendment 4 served to address the data monitoring committee recommendation dated 14 Dec 2011 to discontinue study treatment in all participating patients. It also addressed the subsequent Health Authorities request to implement a 12 month safety follow-up period (actual duration was 9 months in average) post study drug discontinuation.


Recruitment information / eligibility

Status Terminated
Enrollment 8606
Est. completion date February 2013
Est. primary completion date February 2013
Accepts healthy volunteers No
Gender Both
Age group 35 Years and older
Eligibility Inclusion Criteria:

- Type 2 diabetes and at least one of the following:

- Macroalbuminuria and an eGFR =30 mL/min/1.73 m2

- Microalbuminuria and a reduced kidney function (eGFR eGFR =30 and <60 mL/min/1.73 m2)

- A history of CV disease (previous MI, previous stroke, heart failure, coronary artery disease, history of percutaneous coronary intervention, angiography proven stenosis =50% in at least one coronary artery and a reduced kidney function (eGFR =30 and <60 mL/min/1.73 m2)

- Concomitant treatment should follow national guidelines and must include either an Angiotensin-converting-enzyme-inhibitor (ACEi) or an Angiotensin-receptor-blocker (ARB) but not both.

Exclusion Criteria:

- Type 1 diabetes mellitus

- Cardiovascular event or procedure = 3 months prior to Visit 1

- Unstable serum creatinine

- Hypertension: Mean sitting systolic blood pressure (msSBP) = 135 and < 170 mmHg or Mean sitting diastolic blood pressure (msDBP) = 85 and < 110 mmHg unless treated with at least 3 anti-hypertensive medications

- Hypertension msSBP = 170 or msDBP = 110 mmHg

- Baseline Serum Potassium > 5.0 mmol/L

- Patients who are treated with two renin-angiotensin-aldosterone-system-blockers

- Patients with NYHA class III or IV heart failure

- Known renal artery stenosis

- Previous randomization into the AVOID trial (CSPP100C2201)

EXCLUSION SPECIFIC TO THE SAFETY FOLLOW-UP PERIOD:

- Aliskiren or aliskiren containing fixed combination products must not be used

Other protocol-defined inclusion/exclusion criteria applied

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment


Intervention

Drug:
Aliskiren
Aliskiren 150 mg film-coated tablets
Placebo
Placebo to match aliskiren 150 mg film-coated tablets

Locations

Country Name City State
Argentina Novartis Investigative Site Buenos aires
Argentina Novartis Investigative Site Buenos Aires
Argentina Novartis Investigative Site Caba Buenos Aires
Argentina Novartis Investigative Site Caba Buenos Aires
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Venezuela Novartis Investigative Site Caracas Distrito Capital
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Venezuela Novartis Investigative Site Caracas Distrito Capital
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Sponsors (1)

Lead Sponsor Collaborator
Novartis Pharmaceuticals

Countries where clinical trial is conducted

United States,  Venezuela,  Argentina,  Austria,  Belgium,  Brazil,  Canada,  China,  Colombia,  Czech Republic,  Denmark,  Finland,  France,  Germany,  Greece,  Guatemala,  Hungary,  India,  Italy,  Japan,  Korea, Republic of,  Lithuania,  Netherlands,  Norway,  Peru,  Portugal,  Puerto Rico,  Singapore,  Slovakia,  South Africa,  Spain,  Sweden,  Switzerland,  Taiwan,  Thailand,  Turkey,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Other Percentage of Participants With Angioedema/Angioedema-like or Colorectal Events (Core : Active Treatment Phase) AEs of special interest were reported according to a post-marketing commitment to Health Authorities and included angioedema/angioedema-like events and colorectal events/ procedures Time from randomization to the first event (Maximum 50 months) Yes
Other Change From Baseline in Urinary Albumin to Creatinine Ratio (UACR) to Month 6 and to Last Measurement (Core : Active Treatment Phase) Baseline is the geometric mean of last 3 measurements before visit 3, Post-baseline value is the geometric mean of last 3 measurements during each visit.
Change from Baseline = Post - Baseline.
Baseline, Month 6 , last measurement (maximum at 50 months) No
Other Mean Changes in Estimated Glomerular Filtration Rate (eGFR) From Baseline to Month 3 and Month 6 (Core : Active Treatment Phase) The eGFR calculation was based on the Abbreviated Modification of Diet in Renal Disease (MDRD) Study Equation. Using this method, the applicable MDRD formula to calculate eGFR was as follows:
Estimated GFR (mL/min/1.73 m^2) = 175 x (serum creatinine in mg/dL) -1.154 x (Age in years) -0.203 x (0.742 if female) x (1.210 if Black)
Mean changes in eGFR from baseline to month 3 and month 6 were included for analysis. The LS Mean and Standard Error were based on an ANCOVA repeated-measure model with treatment, visit, treatment-by-visit and baseline eGFR as effect terms.
Baseline to Month 3 and Month 6 No
Other Percentage of Participants With Angioedema/Angioedema-like Events or Colorectal Events (Extension Phase) AEs of special interest were reported according to a post-marketing commitment to Health Authorities and included angioedema/angioedema-like events and colorectal events/ procedures. From cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) Yes
Primary Percentage of Participants With Occurrence of Primary Composite Endpoint (Core : Active Treatment Phase) Occurrence was defined as the first event of the following composite primary endpoint:
Cardiovascular (CV) death
Resuscitated sudden death
Non-fatal myocardial infarction (MI)
Non-fatal stroke
Unplanned hospitalization for heart failure (HF)
Onset of end-stage renal disease (ESRD) or death due to renal failure. Onset of ESRD was defined as initiation of dialysis, renal transplantation, or a serum creatinine concentration above 6.0 mg/dL (530 µmol/L), sustained for at least a month.
Doubling of baseline serum creatinine concentration, sustained for at least one month. To fulfill the endpoint, the serum creatinine concentration had to be above the upper limit of normal for men and women according to the central laboratory. The upper limit of normal for men is 1.20 mg/dL and for women is 0.91 mg/dL.
Time from randomization to the first event (Maximum 50 months) No
Primary Percentage of Participants With Cardiovascular (CV) Death (Core: Active Treatment Phase) Time from randomization to the first event (Maximum 50 months) No
Primary Percentage of Participants With Resuscitated Sudden Death (Core: Active Treatment Phase) Resuscitated sudden death was adjudicated when a subject experiences sudden death or cardiac arrest and is successfully resuscitated by cardioversion, defibrillation or cardiopulmonary resuscitation with a meaningful recovery of consciousness. This definition excludes known transient losses of consciousness such as seizure or vasovagal episodes that do not reflect significant cardiac dysfunction. Time from randomization to the first event (Maximum 50 Months) No
Primary Percentage of Participants With Fatal/Non-fatal Myocardial Infarction (MI) (Core: Active Treatment Phase) Time from randomization to the first event (Maximum 50 Months) No
Primary Percentage of Participants With Fatal/Non-fatal Stroke (Core: Active Treatment Phase) Time from randomization to the first event (Maximum 50 Months) No
Primary Percentage of Participants With Onset of End-stage Renal Disease (ESRD) (Core: Active Treatment Phase) ESRD is defined as initiation of dialysis, renal transplantation, or a serum creatinine concentration above 6.0 mg/dL (530 µmol per liter) or renal death Time from randomization to the first event (Maximum 50 Months) No
Primary Percentage of Participants With Doubling of Baseline Serum Creatinine Concentration, Sustained for at Least One Month (Core: Active Treatment Phase) To fulfill the endpoint, the serum creatinine concentration had to be above the upper limit of normal for men and women according to the central laboratory. The upper limit of normal for men is 1.20 mg/dL and for women is 0.91 mg/dL. Time from randomization to the first event (Maximum 50 Months) No
Primary Percentage of Participants With Unplanned Hospitalization for Heart Failure (Core: Active Treatment Phase) Time from randomization to the first event (Maximum 50 Months) No
Primary Percentage of Participants With All Cause Mortality (Core: Active Treatment Phase) Time from randomization to the first event (Maximum 50 months) No
Primary Percentage of Participants With Occurrence of Primary Composite Endpoint (Extension Phase) Occurrence was defined as the first event of the following composite primary endpoint:
Cardiovascular (CV) death
Resuscitated sudden death
Non-fatal myocardial infarction (MI)
Non-fatal stroke
Unplanned hospitalization for heart failure (HF)
Onset of end-stage renal disease (ESRD) or death due to renal failure. Onset of ESRD was defined as initiation of dialysis, renal transplantation, or a serum creatinine concentration above 6.0 mg/dL (530 µmol/L), sustained for at least a month.
Doubling of baseline serum creatinine concentration, sustained for at least one month. To fulfill the endpoint, the serum creatinine concentration had to be above the upper limit of normal for men and women according to the central laboratory. The upper limit of normal for men is 1.20 mg/dL and for women is 0.91 mg/dL.
From cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) No
Primary Percentage of Participants With Cardiovascular (CV) Death (Extension Phase) from cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) No
Primary Percentage of Participants With Resuscitated Sudden Death (Extension Phase) From cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) No
Primary Percentage of Participants Fatal/Non-fatal Myocardial Infarction (MI) (Extension Phase) From cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 month in average) No
Primary Percentage of Participants With Fatal/Non-fatal Stroke (Extension Phase) From cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) No
Primary Percentage of Participants With Onset of End-stage Renal Disease (ESRD) (Extension Phase) ESRD is defined as initiation of dialysis, renal transplantation, or a serum creatinine concentration above 6.0 mg/dL (530 µmol per liter) or renal death From cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) No
Primary Percentage of Participants Doubling of Baseline Serum Creatinine Concentration, Sustained for at Least One Month (Extension Phase) To fulfill the endpoint, the serum creatinine concentration had to be above the upper limit of normal for men and women according to the central laboratory. The upper limit of normal for men is 1.20 mg/dL and for women is 0.91 mg/dL. From cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) No
Primary Percentage of Participants With Unplanned Hospitalization for Heart Failure (Extension Phase) From cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) No
Primary Percentage of Participants With All Cause Mortality (Extension Phase) from cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) No
Secondary Percentage of Participants With Occurrence of Secondary Cardiovascular Composite Endpoint (Core: Active Treatment Phase) Occurrence was defined as the first event of the following secondary cardiovascular composite endpoint:
Cardiovascular (CV) death
Resuscitated sudden death
Non-fatal myocardial infarction (MI)
Non-fatal stroke
Unplanned hospitalization for heart failure (HF)
Time from randomization to the first event (Maximum 50 months) No
Secondary Percentage of Participants With Occurrence of Secondary Renal Composite Endpoint (Core: Active Treatment Phase) Occurrence was defined as the first event of the following secondary renal composite endpoint:
Onset of end-stage renal disease (ESRD) or death due to renal failure. Onset of ESRD was defined as initiation of dialysis, renal transplantation, or a serum creatinine concentration above 6.0 mg/dL (530 µmol/L), sustained for at least a month.
Doubling of baseline serum creatinine concentration, sustained for at least one month. To fulfill the endpoint, the serum creatinine concentration had to be above the upper limit of normal for men and women according to the central laboratory.The upper limit of normal for men is 1.20 mg/dL and for women is 0.91 mg/dL.
Time from randomization to the first event (Maximum 50 months) No
Secondary Percentage of Participants With Occurrence of Secondary Cardiovascular Composite Endpoint (Extension Phase) Occurrence was defined as the first event of the following secondary cardiovascular composite endpoint:
Cardiovascular (CV) death
Resuscitated sudden death
Non-fatal myocardial infarction (MI)
Non-fatal stroke
Unplanned hospitalization for heart failure (HF)
From cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) No
Secondary Percentage of Participants With Occurrence of Secondary Renal Composite Endpoint (Extension Phase) Occurrence was defined as the first event of the following secondary renal composite endpoint:
Onset of end-stage renal disease (ESRD) or death due to renal failure. Onset of ESRD was defined as initiation of dialysis, renal transplantation, or a serum creatinine concentration above 6.0 mg/dL (530 µmol/L), sustained for at least a month.
Doubling of baseline serum creatinine concentration, sustained for at least one month. To fulfill the endpoint, the serum creatinine concentration had to be above the upper limit of normal for men and women according to the central laboratory. The upper limit of normal for men is 1.20 mg/dL and for women is 0.91 mg/dL.
From cut-off date (20Dec2011/End of Treatment (EOT) ) to the first event after cut-off date (9 months in average) No
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