A Prospective, Randomised, Double-blind, Double-dummy, Forced-titration, Multicentre, Parallel Group, One Year Treatment Trial to Compare Telmisartan (MICARDIS) 80 mg Versus Losartan (COZAAR) 100 mg, in Hypertensive Type 2 Diabetic Patients With Overt Nephropathy (AMADEO Study)

NCT ID: NCT00168857

Last Updated: 2023-12-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

860 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-07-09

Brief Summary

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A number of blood pressure lowering drugs in the class known as angiotensin receptor blockers (ARB) have been shown to slow the decline in kidney function of patients with type 2 diabetes, high blood pressure, and kidney disease. Losartan (COZAAR), is one such drug. The purpose of this research study is to determine if after one year of treatment telmisartan (MICARDIS, GLIOSARTAN, KINZAL, KINZALMONO, PREDXAL, PRITOR, SAMERTAN, TELMISARTAN) 80 mg, another blood pressure lowering drug from the ARB class, is as effective as losartan (COZAAR) 100 mg in reducing the level of urinary protein (indicative of improved kidney function).

Detailed Description

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Conditions

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Hypertension Diabetic Nephropathies

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Interventions

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telmisartan

Intervention Type DRUG

losartan

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Ability to provide written informed consent in accordance with Good Clinical Practice (GCP) and local legislation
* Age 21-80 years
* Clinical history of type 2 diabetes mellitus, as defined by either:

* Hyperglycaemia not requiring insulin (diet, oral hypoglycaemic agents and metformin if patients serum creatinine levels were within normal limits.)
* Hyperglycaemia requiring insulin with: no history of diabetic ketoacidosis AND with either the period between diagnosis and insulin usage \>1 year or elevated fasting or stimulated C-peptide level
* Glycosylated haemoglobin A1 (HbA1c) ≤10%
* Diabetic nephropathy, as defined by:

* serum creatinine at Screening (Visit 1) ≤265 μmol/L (3.0 mg/dL) in women and ≤283 μmol/L (3.2 mg/dL) in men
* urinary protein/creatinine ratio ≥700 mg/g (measured in spot urine) during the run-in phase (Visit 2 or Visit 5 retest)
* Hypertension at screening, as defined by either:

* Mean systolic blood pressure (SBP) \>130 mmHg and/or mean diastolic blood pressure (DBP) \>80 mmHg in untreated patients
* Patients currently receiving antihypertensive medication (i.e. medications specifically prescribed to treat hypertension)
* Ability to stop current antihypertensive therapy with Angiotensin Converting Enzyme Inhibitor (ACE-Is), Angiotensin Receptor Blockers (ARBs) and direct vasodilators, and to stop chronic immunosuppressive therapy and current therapy with metformin without risk to the patient (Investigator's discretion).
* All female patients had to have negative results from the urine pregnancy test (UPT) at Visits 1 and 6 in order to be able to continue in the study.

Exclusion Criteria

* Pre-menopausal women (last menstruation ≤1 year prior to signing informed consent) who:

* were not surgically sterile or
* were nursing or pregnant or
* were of child-bearing potential and were not practicing acceptable methods of birth control, or did not plan to continue practicing an acceptable method throughout the study (Note: Acceptable methods of birth control included transdermal patch, intra-uterine device, oral, implantable or injectable contraceptives) AND did not agree to periodic urine pregnancy testing (UPT) during participation in the study. No exceptions were made.
* Type 1 diabetes mellitus
* Increase of serum creatinine \>35% between Visit 1 (Screening) and Visit 5. If creatinine was increased \>35% at Visit 5, the measurement was to be repeated within five calendar days and if the increase was confirmed, the patient had to be excluded from the trial for safety reasons.
* Non-diabetic renal disease
* Congestive heart failure (New York Heart Association functional class III or IV)
* Unstable angina, myocardial infarction, coronary artery bypass graft surgery, or percutaneous coronary intervention within the last three months prior to signing the informed consent form
* Stroke or transient ischaemic attack within the last six months prior to signing the informed consent form
* Hypertrophic obstructive cardiomyopathy, hemodynamically relevant stenosis of the aortic or mitral valve
Minimum Eligible Age

21 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boehringer Ingelheim

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Boehringer Ingelheim Study Coordinator

Role: STUDY_CHAIR

Boehringer Ingelheim

Locations

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Boehringer Ingelheim Investigational Site

Montgomery, Alabama, United States

Site Status

Boehringer Ingelheim Investigational Site

Little Rock, Arkansas, United States

Site Status

Boehringer Ingelheim Investigational Site

Lancaster, California, United States

Site Status

Boehringer Ingelheim Investigational Site

Los Angeles, California, United States

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VA of Greater Los Angeles

Los Angeles, California, United States

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UCI Medical Center

Orange, California, United States

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VA San Diego Healthcare System

San Diego, California, United States

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Boehringer Ingelheim Investigational Site

Santa Ana, California, United States

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UCLA Medical Center

Sylmar, California, United States

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Torrance Clinical Research

Torrance, California, United States

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University of Colorado Health Sciences Center

Denver, Colorado, United States

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Boehringer Ingelheim Investigational Site

Wheat Ridge, Colorado, United States

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George Washington University

Washington D.C., District of Columbia, United States

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Boehringer Ingelheim Investigational Site

Hollywood, Florida, United States

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Boehringer Ingelheim Investigational Site

Largo, Florida, United States

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Boehringer Ingelheim Investigational Site

Ocala, Florida, United States

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Boehringer Ingelheim Investigational Site

Pembroke Pines, Florida, United States

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Boehringer Ingelheim Investigational Site

Tampa, Florida, United States

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Boehringer Ingelheim Investigational Site

Atlanta, Georgia, United States

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Medical College of Georgia

Augusta, Georgia, United States

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Rush Presbyterian - St. Lukes Medical Center

Chicago, Illinois, United States

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Boehringer Ingelheim Investigational Site

Des Moines, Iowa, United States

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Louisiana State University Health Science Center

New Orleans, Louisiana, United States

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Boehringer Ingelheim Investigational Site

Shreveport, Louisiana, United States

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Boehringer Ingelheim Investigational Site

Towson, Maryland, United States

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Boehringer Ingelheim Investigational Site

Boston, Massachusetts, United States

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Boehringer Ingelheim Investigational Site

Springfield, Massachusetts, United States

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Boehringer Ingelheim Investigational Site

Eatontown, New Jersey, United States

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University of Medicine and Dentistry of New Jersey

Newark, New Jersey, United States

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Boehringer Ingelheim Investigational Site

Flushing, New York, United States

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Winthrop University Hospital

Mineola, New York, United States

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Harlem Hospital

New York, New York, United States

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Northport VAMC - Medical Service (111)

Northport, New York, United States

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Wake Nephrology Associates, PA

Raleigh, North Carolina, United States

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The Cleveland Foundation

Cleveland, Ohio, United States

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Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

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Temple University Hospital

Philadelphia, Pennsylvania, United States

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VA Pittsburgh Healthcare System

Pittsburgh, Pennsylvania, United States

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Medical University of South Carolina

Charleston, South Carolina, United States

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The University of Texas Southwestern Medical Center

Dallas, Texas, United States

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Boehringer Ingelheim Investigational Site

San Antonio, Texas, United States

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University of Texas Health and Science Center at San Antonio

San Antonio, Texas, United States

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University of Vermont

Burlington, Vermont, United States

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University of Virginia Health Science Center

Charlottesville, Virginia, United States

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Boehringer Ingelheim Investigational Site

Gig Harbor, Washington, United States

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Boehringer Ingelheim Investigational Site

Seattle, Washington, United States

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Clement J. Zablocki Veterans Administration Medical Center

Milwaukee, Wisconsin, United States

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Boehringer Ingelheim Investigational Site

Buenos Aires, , Argentina

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Clinica Coronel Suarez

Coronel Suárez, , Argentina

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Boehringer Ingelheim Investigational Site

Córdoba, , Argentina

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Boehringer Ingelheim Investigational Site

Paraná, , Argentina

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Boehringer Ingelheim Investigational Site

Provincia de Buenos Aires, , Argentina

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Boehringer Ingelheim Investigational Site

Rosario, Santa Fé, , Argentina

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Hospital San Bernardo

Salta, , Argentina

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Boehringer Ingelheim Investigational Site

Santa Fe, , Argentina

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Boehringer Ingelheim Investigational Site

Kippa-Ring, Queensland, Australia

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Lyell McEwin Hospital Department of medicine

Elizabeth, South Australia, Australia

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Geelong Clinical Research Centre

Geelong, Victoria, Australia

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Boehringer Ingelheim Investigational Site

Melbourne, Victoria, Australia

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Universidade Federal do Pará

Belém, , Brazil

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Boehringer Ingelheim Investigational Site

Botucatu, , Brazil

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Faculdade de Medicina Universidade Federal de Juiz de Fora

Juiz de Fora ¿ MG, , Brazil

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Boehringer Ingelheim Investigational Site

Vila Clementino, São Paulo, , Brazil

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Boehringer Ingelheim Investigational Site

Calgary, Alberta, Canada

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Boehringer Ingelheim Investigational Site

Red Deer, Alberta, Canada

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BC Endocrine Research Foundation

Vancouver, British Columbia, Canada

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Endocrine Research Society

Vancouver, British Columbia, Canada

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University of Manitoba, Diabetes Research Group

Winnipeg, Manitoba, Canada

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Division of Respirology

Halifax, Nova Scotia, Canada

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Boehringer Ingelheim Investigational Site

Kitchener, Ontario, Canada

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Boehringer Ingelheim Investigational Site

London, Ontario, Canada

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Credit Valley Hospital

Mississauga, Ontario, Canada

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Boehringer Ingelheim Investigational Site

Oakville, Ontario, Canada

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The Ottawa Hospital - Riverside Campus

Ottawa, Ontario, Canada

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LIfestyle Metabolism Centre - Thornhill

Thornhill, Ontario, Canada

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Boehringer Ingelheim Investigational Site

Timmins, Ontario, Canada

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Boehringer Ingelheim Investigational Site

Toronto, Ontario, Canada

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St. Michael's Hospital

Toronto, Ontario, Canada

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Sunnybrook & Woman's College Health Science Centre

Toronto, Ontario, Canada

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Humber River Regional Hospital, Dialysis Unit

Weston, Ontario, Canada

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Boehringer Ingelheim Investigational Site

Laval, Quebec, Canada

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CHUM - Hote-Dieu

Montreal, Quebec, Canada

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Hopital Maisonneuve Rosemont

Montreal, Quebec, Canada

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CHUS - Hopital Fleurimont

Sherbrooke, Quebec, Canada

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Boehringer Ingelheim Investigational Site

Saskatoon, Saskatchewan, Canada

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Fracc. Magallanes

Acapulco Guerrero, , Mexico

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Boehringer Ingelheim Investigational Site

Col. Sección XVI, Deleg. Tlalpan, , Mexico

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Cardiology

Guadalajara, , Mexico

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Hospital Civil Nuevo de Guadalajara

Guadalajara, , Mexico

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Boehringer Ingelheim Investigational Site

Guadalajara, Jalisco, , Mexico

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Dep of Neurology

Metepec, , Mexico

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Cardiologia

México, D.F., , Mexico

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Boehringer Ingelheim Investigational Site

Auckland, , New Zealand

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1st Floor Hagely Hostel

Christchurch, , New Zealand

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Dongsan Medical Center

Daegu, , South Korea

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National Health Insurance Corporation, Ilsan Hospital

Gyunggido, , South Korea

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Yongdong Severance Hospital

Seoul, , South Korea

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Buddhist Tzu Chi General Hospital

Chiayi City, , Taiwan

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Buddhist Tzu Chi General Hospital

Hualien City, , Taiwan

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Chi Mei Medical Center

Tainan City, , Taiwan

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Cathay General Hospital

Taipei, , Taiwan

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National Taiwan University Hospital

Taipei, , Taiwan

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Tri-Service General Hospital

Taipei, , Taiwan

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Bumrungrad Hospital

Bangkok, , Thailand

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Pramongkutklao Hospital

Bangkok, , Thailand

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Siriraj Hospital, Division of Hypertension

Bangkok, , Thailand

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Thummasart University Hospital

Bangkok, , Thailand

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Maharaj Nakom Chiang Mai Hospital

Chiang Mai, , Thailand

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Srinagarind Hospital

Khon Kaen, , Thailand

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Countries

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United States Argentina Australia Brazil Canada Mexico New Zealand South Korea Taiwan Thailand

References

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Natale P, Palmer SC, Navaneethan SD, Craig JC, Strippoli GF. Angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers for preventing the progression of diabetic kidney disease. Cochrane Database Syst Rev. 2024 Apr 29;4(4):CD006257. doi: 10.1002/14651858.CD006257.pub2.

Reference Type DERIVED
PMID: 38682786 (View on PubMed)

Bakris G, Burgess E, Weir M, Davidai G, Koval S; AMADEO Study Investigators. Telmisartan is more effective than losartan in reducing proteinuria in patients with diabetic nephropathy. Kidney Int. 2008 Aug;74(3):364-9. doi: 10.1038/ki.2008.204. Epub 2008 May 21.

Reference Type DERIVED
PMID: 18496508 (View on PubMed)

Other Identifiers

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502.397

Identifier Type: -

Identifier Source: org_study_id