Trial Outcomes & Findings for The Effects of Moderate vs. Aggressive Treatment With Valsartan + Amlodipine on Patients With Hypertension Uncontrolled by Angiotensin-Receptor Blocker (Herein, ARB) Monotherapy (NCT NCT00666536)

NCT ID: NCT00666536

Last Updated: 2016-10-27

Results Overview

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

728 participants

Primary outcome timeframe

Baseline and Week 4

Results posted on

2016-10-27

Participant Flow

369 and 359 are the total randomized patients by treatment groups respectively. In the baseline measures tables 366 and 357 are the total patients for the ITT population by treatment group.

Participant milestones

Participant milestones
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Overall Study
STARTED
369
359
Overall Study
COMPLETED
336
322
Overall Study
NOT COMPLETED
33
37

Reasons for withdrawal

Reasons for withdrawal
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Overall Study
Adverse Event
9
19
Overall Study
Unsatisfactory therapeutic effect
2
0
Overall Study
Protocol deviation(s)
8
6
Overall Study
Withdrawal by Subject
10
9
Overall Study
Lost to Follow-up
4
3

Baseline Characteristics

The Effects of Moderate vs. Aggressive Treatment With Valsartan + Amlodipine on Patients With Hypertension Uncontrolled by Angiotensin-Receptor Blocker (Herein, ARB) Monotherapy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
n=366 Participants
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
n=357 Participants
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Total
n=723 Participants
Total of all reporting groups
Age, Customized
< 65 years
302 participants
n=5 Participants
292 participants
n=7 Participants
594 participants
n=5 Participants
Age, Customized
>=65 years
64 participants
n=5 Participants
65 participants
n=7 Participants
129 participants
n=5 Participants
Age, Continuous
54.4 years
STANDARD_DEVIATION 10.98 • n=5 Participants
55.0 years
STANDARD_DEVIATION 10.98 • n=7 Participants
54.7 years
STANDARD_DEVIATION 10.98 • n=5 Participants
Sex: Female, Male
Female
157 Participants
n=5 Participants
157 Participants
n=7 Participants
314 Participants
n=5 Participants
Sex: Female, Male
Male
209 Participants
n=5 Participants
200 Participants
n=7 Participants
409 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline and Week 4

Population: Intent to treat (ITT), Last observation carried forward (LOCF)

Outcome measures

Outcome measures
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
n=366 Participants
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
n=357 Participants
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Change From Baseline to Week 4 in Mean Sitting Systolic Blood Pressure (MSSBP)
Baseline MSSBP
163.9 mmHg
Standard Deviation 11.85
163.3 mmHg
Standard Deviation 11.40
Change From Baseline to Week 4 in Mean Sitting Systolic Blood Pressure (MSSBP)
Week 4 MSSBP
140.9 mmHg
Standard Deviation 14.61
144.4 mmHg
Standard Deviation 14.21
Change From Baseline to Week 4 in Mean Sitting Systolic Blood Pressure (MSSBP)
Change From Baseline to Week 4 in MSSBP
-23.0 mmHg
Standard Deviation 14.60
-18.9 mmHg
Standard Deviation 13.92

SECONDARY outcome

Timeframe: Weeks 2, 4, 8 and 12

Population: Intent to treat (ITT), Last observation carried forward (LOCF)

Outcome measures

Outcome measures
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
n=366 Participants
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
n=357 Participants
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Percentage of Patients Achieving the Blood Pressure (BP) Goal of < 140/90 mmHg at Weeks 2,4,8 and 12
Week 2
25.1 Percentage of Patients
25.8 Percentage of Patients
Percentage of Patients Achieving the Blood Pressure (BP) Goal of < 140/90 mmHg at Weeks 2,4,8 and 12
Week 4
43.7 Percentage of Patients
31.1 Percentage of Patients
Percentage of Patients Achieving the Blood Pressure (BP) Goal of < 140/90 mmHg at Weeks 2,4,8 and 12
Week 8
61.7 Percentage of Patients
46.2 Percentage of Patients
Percentage of Patients Achieving the Blood Pressure (BP) Goal of < 140/90 mmHg at Weeks 2,4,8 and 12
Week 12
59.8 Percentage of Patients
50.7 Percentage of Patients

SECONDARY outcome

Timeframe: Baseline and Week 4

Population: Intent to treat (ITT), Last observation carried forward (LOCF)

Outcome measures

Outcome measures
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
n=366 Participants
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
n=357 Participants
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Change From Baseline to Week 4 in Mean Sitting Diastolic Blood Pressure (MSDBP)
Baseline MSDBP
95.5 mmHg
Standard Deviation 11.19
95.0 mmHg
Standard Deviation 10.33
Change From Baseline to Week 4 in Mean Sitting Diastolic Blood Pressure (MSDBP)
Week 4 MSDBP
84.8 mmHg
Standard Deviation 11.47
86.2 mmHg
Standard Deviation 9.6
Change From Baseline to Week 4 in Mean Sitting Diastolic Blood Pressure (MSDBP)
Change From Baseline to Week 4 in MSDBP
-10.7 mmHg
Standard Deviation 9.39
-8.8 mmHg
Standard Deviation 9.08

SECONDARY outcome

Timeframe: Baseline and Weeks 2, 8 and 12

Population: Intent to treat (ITT), Last observation carried forward (LOCF)

Outcome measures

Outcome measures
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
n=366 Participants
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
n=357 Participants
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Change From Baseline to Weeks 2, 8 and 12 in MSSBP
Baseline MSSBP
163.9 mmHg
Standard Deviation 11.85
163.3 mmHg
Standard Deviation 11.40
Change From Baseline to Weeks 2, 8 and 12 in MSSBP
Week 2 MSSBP
147.0 mmHg
Standard Deviation 14.93
146.0 mmHg
Standard Deviation 14.80
Change From Baseline to Weeks 2, 8 and 12 in MSSBP
Change From Baseline to Week 2 in MSSBP
-16.9 mmHg
Standard Deviation 13.94
-17.3 mmHg
Standard Deviation 13.80
Change From Baseline to Weeks 2, 8 and 12 in MSSBP
Week 8 MSSBP
136.0 mmHg
Standard Deviation 15.27
140.5 mmHg
Standard Deviation 15.91
Change From Baseline to Weeks 2, 8 and 12 in MSSBP
Change From Baseline to Week 8 in MSSBP
-27.9 mmHg
Standard Deviation 16.08
-22.8 mmHg
Standard Deviation 16.15
Change From Baseline to Weeks 2, 8 and 12 in MSSBP
Week 12 MSSBP
135.7 mmHg
Standard Deviation 14.97
139.2 mmHg
Standard Deviation 15.63
Change From Baseline to Weeks 2, 8 and 12 in MSSBP
Change From Baseline to Week 12 in MSSBP
-28.1 mmHg
Standard Deviation 16.59
-24.1 mmHg
Standard Deviation 16.07

SECONDARY outcome

Timeframe: Baseline and Weeks 2, 8 and 12

Population: Intent to treat (ITT), Last observation carried forward (LOCF)

Outcome measures

Outcome measures
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
n=366 Participants
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
n=357 Participants
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Change From Baseline to Weeks 2, 8 and 12 in MSDBP
Baseline MSDBP
95.5 mmHg
Standard Deviation 11.19
95.0 mmHg
Standard Deviation 10.33
Change From Baseline to Weeks 2, 8 and 12 in MSDBP
Week 2 MSDBP
88.2 mmHg
Standard Deviation 10.93
87.1 mmHg
Standard Deviation 10.38
Change From Baseline to Weeks 2, 8 and 12 in MSDBP
Change From Baseline to Week 2 in MSDBP
-7.3 mmHg
Standard Deviation 8.51
-7.9 mmHg
Standard Deviation 9.66
Change From Baseline to Weeks 2, 8 and 12 in MSDBP
Week 8 MSDBP
81.6 mmHg
Standard Deviation 11.15
84.0 mmHg
Standard Deviation 11.39
Change From Baseline to Weeks 2, 8 and 12 in MSDBP
Change From Baseline to Week 8 in MSDBP
-13.9 mmHg
Standard Deviation 9.97
-11.0 mmHg
Standard Deviation 10.33
Change From Baseline to Weeks 2, 8 and 12 in MSDBP
Week 12 MSDBP
81.5 mmHg
Standard Deviation 10.62
83.8 mmHg
Standard Deviation 10.61
Change From Baseline to Weeks 2, 8 and 12 in MSDBP
Change From Baseline to Week 12 in MSDBP
-14.0 mmHg
Standard Deviation 10.41
-11.2 mmHg
Standard Deviation 10.48

SECONDARY outcome

Timeframe: Weeks 2, 4, 8 and 12

Population: Intent to treat (ITT), Last observation carried forward (LOCF)

Outcome measures

Outcome measures
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
n=366 Participants
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
n=357 Participants
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Percentage of Patients Achieving BP Goal of MSSBP < 140mmHg at Weeks 2, 4, 8 and 12
Week 2
31.1 Percentage of Patients
32.5 Percentage of Patients
Percentage of Patients Achieving BP Goal of MSSBP < 140mmHg at Weeks 2, 4, 8 and 12
Week 4
49.2 Percentage of Patients
37.5 Percentage of Patients
Percentage of Patients Achieving BP Goal of MSSBP < 140mmHg at Weeks 2, 4, 8 and 12
Week 8
66.1 Percentage of Patients
49.6 Percentage of Patients
Percentage of Patients Achieving BP Goal of MSSBP < 140mmHg at Weeks 2, 4, 8 and 12
Week 12
62.8 Percentage of Patients
55.7 Percentage of Patients

Adverse Events

Aggressive Treatment Regimen (5/320 mg to 10/320 mg)

Serious events: 4 serious events
Other events: 50 other events
Deaths: 0 deaths

Moderate Treatment Regimen (5/160 mg)

Serious events: 10 serious events
Other events: 29 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
n=369 participants at risk
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
n=359 participants at risk
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Cardiac disorders
Angina pectoris
0.00%
0/369 • 12 weeks
0.56%
2/359 • 12 weeks
Cardiac disorders
Cardiac arrest
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Cardiac disorders
Cardiac failure congestive
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Cardiac disorders
Myocardial infarction
0.00%
0/369 • 12 weeks
0.56%
2/359 • 12 weeks
Cardiac disorders
Palpitations
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Cardiac disorders
Tachycardia
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Gastrointestinal disorders
Abdominal pain
0.00%
0/369 • 12 weeks
0.56%
2/359 • 12 weeks
Gastrointestinal disorders
Small intestinal obstruction
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
General disorders
Chest pain
0.27%
1/369 • 12 weeks
0.00%
0/359 • 12 weeks
General disorders
Gait disturbance
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
General disorders
Non-cardiac chest pain
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Infections and infestations
Diverticulitis
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Infections and infestations
Pneumonia bacterial
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Investigations
Electrocardiogram T wave abnormal
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Metabolism and nutrition disorders
Diabetic ketoacidosis
0.27%
1/369 • 12 weeks
0.00%
0/359 • 12 weeks
Metabolism and nutrition disorders
Type 1 diabetes mellitus
0.27%
1/369 • 12 weeks
0.00%
0/359 • 12 weeks
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Breast cancer
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Breast cancer in situ
0.27%
1/369 • 12 weeks
0.00%
0/359 • 12 weeks
Nervous system disorders
Balance disorder
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Nervous system disorders
Hypoaesthesia
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Psychiatric disorders
Depression
0.27%
1/369 • 12 weeks
0.00%
0/359 • 12 weeks
Psychiatric disorders
Suicide attempt
0.27%
1/369 • 12 weeks
0.00%
0/359 • 12 weeks
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Respiratory, thoracic and mediastinal disorders
Dyspnoea
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Respiratory, thoracic and mediastinal disorders
Orthopnoea
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks
Vascular disorders
Hypertension
0.00%
0/369 • 12 weeks
0.28%
1/359 • 12 weeks

Other adverse events

Other adverse events
Measure
Aggressive Treatment Regimen (5/320 mg to 10/320 mg)
n=369 participants at risk
Valsartan + Amlodipine, daily: 320 mg + 5 mg (2 weeks); Valsartan + Amlodipine, daily: 320 mg + 10 mg (2 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 320 mg + 10 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
Moderate Treatment Regimen (5/160 mg)
n=359 participants at risk
Valsartan + Amlodipine, daily dose: 160 mg + 5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg (4 weeks); Valsartan + Amlodipine and Hydrochlorothiazide, daily: 160 mg + 5 mg and 12.5 mg or 25 mg (optional titration) (4 weeks)
General disorders
Oedema peripheral
8.7%
32/369 • 12 weeks
4.5%
16/359 • 12 weeks
Nervous system disorders
Dizziness
5.1%
19/369 • 12 weeks
3.9%
14/359 • 12 weeks

Additional Information

Study Director

Novartis Pharmaceuticals

Phone: 862-778-8300

Results disclosure agreements

  • Principal investigator is a sponsor employee The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of the pooled data (i.e., data from all sites) in the clinical trial.
  • Publication restrictions are in place

Restriction type: OTHER