AARDVARK (Aortic Aneurysmal Regression of Dilation: Value of ACE-Inhibition on RisK)

NCT ID: NCT01118520

Last Updated: 2021-01-26

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

224 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-09-30

Study Completion Date

2015-04-30

Brief Summary

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Abdominal aortic aneurysms (AAA) are balloon-like swellings of the body's main blood vessel (aorta) as it courses through the abdomen. As a result of the National Aneurysm Screening programme many more of these will be detected. Small AAAs grow slowly and remain a benign condition until the diameter exceeds 2-3 times the diameter of the normal aorta (about 5.5cm in size), when operative repair of the aneurysm is recommended avoiding the potentially fatal event of bursting and bleeding (aneurysm rupture). It is therefore important to identify a strategy to prevent aneurysm growth.

There is a suggestion that the use of a specific drug class, angiotensin converting enzyme (ACE) inhibitors, may reduce the risk of rupture of the larger aneurysms. This trial will assess whether an ACE inhibitor (perindopril) has aneurysm-related benefits, in patients with small AAAs at screening centres in the London area.

The effects of perindopril versus a placebo(dummy) on AAA growth rates will be compared. In addition by comparing the effects of perindopril with the effects of equivalent blood pressure lowering with another non-ACE inhibitor class of drug (amlodipine) on aneurysm growth rate, we can see whether any benefits of perindopril are simply the result of lowering blood pressure. 225 Patients will be assigned to one of these 3 treatments by chance (randomisation).In addition to analysis of the effect of perindopril and blood pressure lowering,the effect of the treatments on quality of life will be assessed. Patients will return at 3-monthly intervals for an ultrasound scan and blood pressure measurements, with questionnaires regarding quality of life at the start and end of the 2-year research period.

An ultrasound scan is a painless test that uses sound waves to create images of organs and structures inside your body.

Detailed Description

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This trial will investigate the idea that an ACE-inhibitor reduces abdominal aortic aneurysm (AAA) growth rate, in a pilot 3-arm randomised controlled trial (i.e. the study treatment is chosen by random for each patient). The three interventions are ACE-inhibition with perindopril; equivalent blood pressure reduction with amlodipine (a calcium channel blocker) and a placebo tablet. By comparing the effects in the perindopril and amlodipine arms, this design will permit an evaluation of any blood pressure independent effects of perindopril.

Pending results of this pilot trial, we plan to work with the local and National Aneurysm Screening programme to conduct a larger, definitive trial, to investigate the hypothesis that blood pressure reduction with an ACE-inhibitor slows the rate of small AAA growth preferentially compared with other antihypertensive agents.

Secondary research questions in this trial are the effects of perindopril therapy on aneurysm-related death rates, other diseases possibly caused by an AAA and quality of life compared to similar blood pressure lowering effects with amlodipine and placebo.

Conditions

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Abdominal Aortic Aneurysm

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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perindopril

ACE inhibitor blood pressure lowering agent

Group Type ACTIVE_COMPARATOR

perindopril arginine

Intervention Type DRUG

10mgs orally daily for the duration of the trial

amlodipine

calcium channel blocker blood pressure lowering agent

Group Type ACTIVE_COMPARATOR

amlodipine 5mgs

Intervention Type DRUG

5 mgs taken orally daily for the duration of the trial

placebo

inactive substance identical in appearance to the othe two comparators

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

one daily

Interventions

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perindopril arginine

10mgs orally daily for the duration of the trial

Intervention Type DRUG

amlodipine 5mgs

5 mgs taken orally daily for the duration of the trial

Intervention Type DRUG

placebo

one daily

Intervention Type DRUG

Other Intervention Names

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coversyl arginine

Eligibility Criteria

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Inclusion Criteria

Willing and able to give written informed consent

Men or women, aged at least 55 years

With AAA 3 to 5.4 cm in diameter by internal or external measurement according to ultrasound

A systolic BP \<150mmHg (unless they require and are already receiving an ACE-inhibitor or amlodipine 10mg daily).

Exclusion Criteria

Patients who are already required to take either an ACE-inhibitor or a calcium channel blocker or Angiotensin II blocker (ARB) who cannot be converted to diuretic therapy and/ora 5mg dose of amlodipine for control (ie SBP \< 150mmHg) of their BP.

Those with known renal artery stenosis (\>50%), or with a serum creatinine of \>180µmol/L

Those unable to give informed consent

Those too frail to travel for 3-monthly surveillance will be excluded

Any clinically significant medical condition which, in the opinion of the investigator, may interfere with the study results and or reduce life expectancy to \< 2 years

Participation in another trial of an investigational product or device within the previous 30 days

Known allergy or sensitivity to perindopril or amlodipine

Unable or unwilling to comply with the requirements of the study, in the opinion of the investigator.
Minimum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute for Health Research, United Kingdom

OTHER_GOV

Sponsor Role collaborator

Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Janet Powell, MD

Role: STUDY_DIRECTOR

Imperial College London

Colin Bicknell, FRCS

Role: STUDY_DIRECTOR

Imperial College London

Deborah Ashby, PhD

Role: STUDY_DIRECTOR

Imperial College London

Meryl E Davis, FRCS

Role: PRINCIPAL_INVESTIGATOR

Royal Free Hospital NHS Trust

Mathew Waltham, FRCS

Role: PRINCIPAL_INVESTIGATOR

Guys Hospital NHS trust

Neil Poulter, FRCP

Role: STUDY_DIRECTOR

Imperial College London

Christopher Imray, FRCS

Role: PRINCIPAL_INVESTIGATOR

University Hospitals Coventry & Warwickshire

Dynesh Rittoo, FRCS

Role: PRINCIPAL_INVESTIGATOR

The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

Ian Chetter, FRCS

Role: PRINCIPAL_INVESTIGATOR

Hull University Teaching Hospitals NHS Trust

Sohail Choksy, FRCS

Role: PRINCIPAL_INVESTIGATOR

East Suffolk and North Essex NHS Foundation Trust

Tim Lees, FRCS

Role: PRINCIPAL_INVESTIGATOR

The Newcastle Hospitals NHS Foundation Trust

Andrew Thompson, FRCS

Role: PRINCIPAL_INVESTIGATOR

York Teaching Hospital NHS Foundation Trust

Vince Smyth, FRCS

Role: PRINCIPAL_INVESTIGATOR

Manchester University NHS Foundation Trust

Shah Nawaz, FRCS

Role: PRINCIPAL_INVESTIGATOR

Sheffield Teaching Hospitals NHS Foundation Trust

Andrew Brown, FRCS

Role: PRINCIPAL_INVESTIGATOR

City Hospitals Sunderland NHS Foundation Trust

Felicity Meyer, FRCS

Role: PRINCIPAL_INVESTIGATOR

Norfolk and Norwich University Hospitals NHS Foundation Trust

Locations

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The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

Bournemouth, , United Kingdom

Site Status

Colchester Hospital

Colchester, , United Kingdom

Site Status

University Hospital Coventry and Warwickshire

Coventry, , United Kingdom

Site Status

Hull Royal Infirmary

Hull, , United Kingdom

Site Status

Royal Free Hospital

London, , United Kingdom

Site Status

St Thomas' Hospital

London, , United Kingdom

Site Status

St Mary's Hospital, Imperial College Healthcare NHS Trust

London, , United Kingdom

Site Status

Charing Cross Hospital, Imperial College NHS Trust

London, , United Kingdom

Site Status

Freeman Hospital

Newcastle, , United Kingdom

Site Status

Countries

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United Kingdom

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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2010-020226-17

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

08/109/02

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

CRO1644

Identifier Type: -

Identifier Source: org_study_id

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