Trial Outcomes & Findings for A Study to Investigate the Pharmacodynamic and Pharmacokinetic Interaction Between Aliskiren and Furosemide in Patients With Heart Failure (NCT NCT01125514)

NCT ID: NCT01125514

Last Updated: 2012-09-10

Results Overview

Efficacy of furosemide for sodium excretion (efficacy index 1) was defined by dividing urinary sodium excretion by the urinary excretion of furosemide. Diuretic index 1 for sodium was calculated for the for the total 0 to 4 hour urine collection.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

37 participants

Primary outcome timeframe

0 to 4 hours

Results posted on

2012-09-10

Participant Flow

Participant milestones

Participant milestones
Measure
Furosemide (Fu) /Fu+Aliskiren(Alis)150mg/fu+Alis 300mg
Treatment period 1 (Day 1 to Day 7): All eligible patients received 60 mg furosemide, 150 mg placebo of aliskiren, and 300 mg placebo aliskiren once daily. Treatment Period 2 (Day 8 to day 17): Patients received 60 mg furosemide, 150 mg aliskiren and 300 mg placebo once daily. Treatment Period 3 (Day 18 to day 27): Patients received 60 mg furosemide, 300 mg aliskiren and 150 mg placebo of aliskiren once daily. Day 28, no study treatment.
Treatment Period 1 (Day 1 - Day 7)
STARTED
37
Treatment Period 1 (Day 1 - Day 7)
COMPLETED
35
Treatment Period 1 (Day 1 - Day 7)
NOT COMPLETED
2
Treatment Period 2 (Day 8 - Day 17)
STARTED
35
Treatment Period 2 (Day 8 - Day 17)
Pharmacokinetic (PK) Analysis Set
33
Treatment Period 2 (Day 8 - Day 17)
Pharmacodynamics (PD) Analysis Set
33
Treatment Period 2 (Day 8 - Day 17)
COMPLETED
32
Treatment Period 2 (Day 8 - Day 17)
NOT COMPLETED
3
Treatment Period2(Day9-Day27) and Day 28
STARTED
32
Treatment Period2(Day9-Day27) and Day 28
COMPLETED
28
Treatment Period2(Day9-Day27) and Day 28
NOT COMPLETED
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Furosemide (Fu) /Fu+Aliskiren(Alis)150mg/fu+Alis 300mg
Treatment period 1 (Day 1 to Day 7): All eligible patients received 60 mg furosemide, 150 mg placebo of aliskiren, and 300 mg placebo aliskiren once daily. Treatment Period 2 (Day 8 to day 17): Patients received 60 mg furosemide, 150 mg aliskiren and 300 mg placebo once daily. Treatment Period 3 (Day 18 to day 27): Patients received 60 mg furosemide, 300 mg aliskiren and 150 mg placebo of aliskiren once daily. Day 28, no study treatment.
Treatment Period 1 (Day 1 - Day 7)
Adverse Event
1
Treatment Period 1 (Day 1 - Day 7)
Administrative problems
1
Treatment Period 2 (Day 8 - Day 17)
Adverse Event
3
Treatment Period2(Day9-Day27) and Day 28
Adverse Event
2
Treatment Period2(Day9-Day27) and Day 28
Protocol Deviation
1
Treatment Period2(Day9-Day27) and Day 28
Withdrawal by Subject
1

Baseline Characteristics

A Study to Investigate the Pharmacodynamic and Pharmacokinetic Interaction Between Aliskiren and Furosemide in Patients With Heart Failure

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Furosemide (Fu) /Fu+Aliskiren(Alis)150mg/fu+Alis 300mg
n=37 Participants
Treatment period 1 (Day 1 to Day 7): All eligible patients received 60 mg furosemide, 150 mg placebo of aliskiren, and 300 mg placebo aliskiren once daily. Treatment Period 2 (Day 8 to day 17): Patients received 60 mg furosemide, 150 mg aliskiren and 300 mg placebo once daily. Treatment Period 3 (Day 18 to day 27): Patients received 60 mg furosemide, 300 mg aliskiren and 150 mg placebo of aliskiren once daily. Day 28, no study treatment.
Age Continuous
59.6 years
STANDARD_DEVIATION 11.90 • n=5 Participants
Sex: Female, Male
Female
3 Participants
n=5 Participants
Sex: Female, Male
Male
34 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 0 to 4 hours

Population: All patients who received at least one dose of study drug and had evaluable pharmacodynamic (PD) data with no major protocol deviation in at least one period were included in the PD analysis set.

Efficacy of furosemide for sodium excretion (efficacy index 1) was defined by dividing urinary sodium excretion by the urinary excretion of furosemide. Diuretic index 1 for sodium was calculated for the for the total 0 to 4 hour urine collection.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=33 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=32 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Diuretic Efficacy Index 1 for Sodium Excretion
10.185 mmol/mg
Standard Deviation 4.4568
12.122 mmol/mg
Standard Deviation 6.2867
13.453 mmol/mg
Standard Deviation 8.3524
12.858 mmol/mg
Standard Deviation 6.1040

PRIMARY outcome

Timeframe: 0 to 24 hours

Population: All patients who received at least one dose of study drug and had evaluable pharmacodynamic (PD) data with no major protocol deviation in at least one period were included in the PD analysis set.

Efficacy of furosemide for sodium excretion (efficacy index 1) was defined by dividing urinary sodium excretion by the urinary excretion of furosemide. Diuretic index 1 for sodium was calculated for the for the total 0 to 24 hour urine collection.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=31 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=30 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Diuretic Efficacy Index 1 for Sodium Excretion
10.775 mmol/mg
Standard Deviation 5.2486
13.264 mmol/mg
Standard Deviation 6.3535
13.364 mmol/mg
Standard Deviation 6.1511
14.747 mmol/mg
Standard Deviation 6.3531

PRIMARY outcome

Timeframe: 0 to 4 hours

Population: All patients who received at least one dose of study drug and had evaluable PD data with no major protocol deviation in at least one period were included in the PD analysis set.

Efficacy of furosemide for water excretion (efficacy index 2) was defined by dividing urine volume by the urinary excretion of furosemide.Diuretic index 2 for water was calculated for the 0 to 4 hour fraction urine collection.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=33 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=32 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Diuretic Efficacy Index 2 for Water Excretion
90.402 mL/mg
Standard Deviation 34.7866
109.773 mL/mg
Standard Deviation 50.2433
119.239 mL/mg
Standard Deviation 63.3655
122.157 mL/mg
Standard Deviation 58.8815

PRIMARY outcome

Timeframe: 0 to 24 hours

Population: All patients who received at least one dose of study drug and had evaluable PD data with no major protocol deviation in at least one period were included in the PD analysis set.

Efficacy of furosemide for water excretion (efficacy index 2) was defined by dividing urine volume by the urinary excretion of furosemide.Diuretic index 2 for water was calculated for the 0 to 4 hour fraction and for the total 0 to 24 hour urine collection.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=31 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=32 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=30 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Diuretic Efficacy Index 2 for Water Excretion
119.439 mL/mg
Standard Deviation 46.2607
151.859 mL/mg
Standard Deviation 53.6734
154.116 mL/mg
Standard Deviation 40.5598
175.112 mL/mg
Standard Deviation 59.4236

SECONDARY outcome

Timeframe: pre-dose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10 and 24 hours post dose

Population: All patients who received at least one dose of study drug and had evaluable Pharmacokinetic (PK) data with no major protocol deviation in at least one period were included in the PK analysis set.

Pharmacokinetic (PK) parameters were determined from the plasma concentration time profile of furosemide using a non-compartmental method: AUCtau: Area under the plasma concentration-time curve from time zero to the end of the dosing interval AUC (0-24): Area under the plasma concentration-time curve from time zero to 24 hours AUClast: Area under the plasma concentration-time curve from time zero to the time of the last quantifiable concentration. AUClast was calculated as the sum of linear trapezoids using non-compartmental analysis. AUCinf: Area under the plasma concentration-time curve from time zero to infinity. AUCinf was calculated by adding AUClast and the value obtained from dividing the last measurable plasma concentration by λz, where λz was determined from automated linear regression of the last three time points with non-zero concentrations in the terminal phase of the log-transformed concentration-time profile

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=33 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Plasma Pharmacokinetics (PK) of Furosemide: Area Under the Plasma Concentration-time Curve (AUC)
AUClast
5154 h*ng/mL
Standard Deviation 1999.2
4207 h*ng/mL
Standard Deviation 1387.5
4535 h*ng/mL
Standard Deviation 1531.6
4130 h*ng/mL
Standard Deviation 1525.4
Plasma Pharmacokinetics (PK) of Furosemide: Area Under the Plasma Concentration-time Curve (AUC)
AUCtau
5217 h*ng/mL
Standard Deviation 1996.7
4255 h*ng/mL
Standard Deviation 1390.6
4638 h*ng/mL
Standard Deviation 1532.9
4218 h*ng/mL
Standard Deviation 1469.3
Plasma Pharmacokinetics (PK) of Furosemide: Area Under the Plasma Concentration-time Curve (AUC)
AUC
5217 h*ng/mL
Standard Deviation 1996.7
4255 h*ng/mL
Standard Deviation 1390.6
4638 h*ng/mL
Standard Deviation 1532.9
4218 h*ng/mL
Standard Deviation 1469.3
Plasma Pharmacokinetics (PK) of Furosemide: Area Under the Plasma Concentration-time Curve (AUC)
AUCinf
5420 h*ng/mL
Standard Deviation 2005.2
4559 h*ng/mL
Standard Deviation 1387.4
4783 h*ng/mL
Standard Deviation 1611.7
4381 h*ng/mL
Standard Deviation 1578.3

SECONDARY outcome

Timeframe: pre-dose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10 and 24 hours post dose

Population: All patients who received at least one dose of study drug and had evaluable pharmacokinetic (PK) data with no major protocol deviation in at least one period were included in the PK analysis set

Cmax,ss was directly determined from the raw plasma concentration-time data.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=33 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Plasma Pharmacokinetics (PK) of Furosemide: Observed Maximum Plasma Concentration Following Drug Administration at Steady State (Cmax, ss)
1702 ng/mL
Standard Deviation 708.66
1326 ng/mL
Standard Deviation 518.15
1317 ng/mL
Standard Deviation 542.73
1180 ng/mL
Standard Deviation 404.92

SECONDARY outcome

Timeframe: pre-dose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10 and 24 hours post dose

Population: All patients who received at least one dose of study drug and had evaluable PK data with no major protocol deviation in at least one period were included in the PK analysis set

Tmax was directly determined from the raw plasma concentration-time data.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=33 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Plasma Pharmacokinetics (PK) of Furosemide: Time to Reach the Maximum Concentration After Drug Administration (Tmax)
1.500 Hours
Interval 1.0 to 3.0
1.500 Hours
Interval 0.5 to 3.0
1.500 Hours
Interval 1.0 to 4.0
2.00 Hours
Interval 0.5 to 3.0

SECONDARY outcome

Timeframe: pre-dose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10 and 24 hours post dose

Population: All subjects with evaluable pharmacokinetic parameter data with no exclusion flags and no major protocol deviations.

The average steady-state drug concentration in the plasma, blood, serum, or other body fluids during multiple dosing \[amount x volume-1\]. This was estimated as AUCτ/τ

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=33 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Plasma Pharmacokinetics (PK) of Furosemide: Average Steady State Plasma Concentration During Multiple Dosing (Cav,ss)
217.4 ng/mL
Standard Deviation 83.196
177.3 ng/mL
Standard Deviation 57.942
193.2 ng/mL
Standard Deviation 63.872
175.8 ng/mL
Standard Deviation 61.219

SECONDARY outcome

Timeframe: pre-dose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 24 hours post dose

Population: All patients who received at least one dose of study drug and had evaluable PK data with no major protocol deviation in at least one period were included in the PK analysis set

The minimum observed steady-state drug concentration in the plasma, blood, serum, or other body fluids at the end of the dosing interval during multiple dosing \[amount x volume-1\]

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=33 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Plasma Pharmacokinetics (PK) of Furosemide: Lowest Plasma Concentration Observed During a Dosing Interval at Steady State (Cmin, ss)
20.42 ng/mL
Standard Deviation 25.558
20.03 ng/mL
Standard Deviation 23.780
19.80 ng/mL
Standard Deviation 29.258
16.70 ng/mL
Standard Deviation 20.868

SECONDARY outcome

Timeframe: 0 to 4, 4 to 8, 8 to 12 and 12 to 24 hours post dose

Population: All patients who received at least one dose of study drug and had evaluable PK data with no major protocol deviation in at least one period were included in the PK analysis set

The area under the plasma (or serum or blood) concentration-time curve from time zero to 24 h \[mass × time × volume-1\]

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=31 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=30 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Urine Pharmacokinetics (PK) of Furosemide: Amount of Drug Excreted Into the Urine From Time Zero to 24 Hours After Administration (Ae0-24)
18.61 mg
Standard Deviation 5.9012
15.08 mg
Standard Deviation 3.9613
14.98 mg
Standard Deviation 4.5264
13.63 mg
Standard Deviation 4.5134

SECONDARY outcome

Timeframe: 0 to 4, 4 to 8, 8 to 12 and 12 to 24 hours post dose

Population: All patients who received at least one dose of study drug and had evaluable pharmacodynamic (PD) data with no major protocol deviation in at least one period were included in the PD analysis set.

The renal clearance of drug \[volume x time-1\]

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=31 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=30 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Urine Pharmacokinetics (PK) of Furosemide: Renal Clearance (CLR)
3.808 L/h
Standard Deviation 1.3567
3.841 L/h
Standard Deviation 1.4321
3.519 L/h
Standard Deviation 1.3592
3.561 L/h
Standard Deviation 1.4458

SECONDARY outcome

Timeframe: 0 to 4, 4 to 8, 8 to 12 and 12 to 24 hours post dose

Population: All patients who received at least one dose of study drug and had evaluable PD data with no major protocol deviation in at least one period were included in the PD analysis set.

Creatinine clearance= (Urine creatinine/Serum creatinine) x (Urine volume/(24\*60)).

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=32 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=32 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=29 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Creatinine Clearance
104.745 mL/min
Standard Deviation 38.2884
109.657 mL/min
Standard Deviation 30.0667
103.841 mL/min
Standard Deviation 28.2845
105.304 mL/min
Standard Deviation 25.4076

SECONDARY outcome

Timeframe: 4 hours postdose

Population: All patients who received at least one dose of study drug and had evaluable pharmacodynamics (PD)data with no major protocol deviation in at least one period were included in the PD analysis set.

Urine was collected 4 hours postdose in all treatment groups for sodium and potassium analysis. Each patient was required to void their bladder before drug administration and at the end 4 hours.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=33 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=32 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Urine Sodium and Potassium Excretion Per Treatment at 4 Hours Postdose
Sodium excretion
113.992 mmol
Standard Deviation 47.5976
104.031 mmol
Standard Deviation 49.5036
98.691 mmol
Standard Deviation 55.0495
93.341 mmol
Standard Deviation 43.9419
Urine Sodium and Potassium Excretion Per Treatment at 4 Hours Postdose
Potassium excretion
24.555 mmol
Standard Deviation 11.9749
19.403 mmol
Standard Deviation 10.5975
23.046 mmol
Standard Deviation 8.6829
21.037 mmol
Standard Deviation 7.9355

SECONDARY outcome

Timeframe: 8 hours postdose

Population: All patients who received at least one dose of study drug and had evaluable pharmacodynamics (PD)data with no major protocol deviation in at least one period were included in the PD analysis set.

Urine was collected 8 hours postdose in all treatment groups for sodium and potassium analysis. Each patient was required to void their bladder before drug administration and at the end 8 hours.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=33 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Urine Sodium and Potassium Excretion Per Treatment at 8 Hours Postdose
Sodium excretion
129.990 mmol
Standard Deviation 49.2835
123.835 mmol
Standard Deviation 56.2734
125.677 mmol
Standard Deviation 58.6125
119.776 mmol
Standard Deviation 59.0523
Urine Sodium and Potassium Excretion Per Treatment at 8 Hours Postdose
Potassium excretion
33.474 mmol
Standard Deviation 12.2417
28.068 mmol
Standard Deviation 12.5292
36.120 mmol
Standard Deviation 14.4509
32.498 mmol
Standard Deviation 9.6174

SECONDARY outcome

Timeframe: 12 hours postdose

Population: All patients who received at least one dose of study drug and had evaluable pharmacodynamics (PD)data with no major protocol deviation in at least one period were included in the PD analysis set.

Urine was collected 12 hours postdose in all treatment groups for sodium and potassium analysis. Each patient was required to void their bladder before drug administration and at the end 12 hours.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=32 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=32 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=27 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Urine Sodium and Potassium Excretion Per Treatment at 12 Hours Postdose
Sodium excretion
151.254 mmol
Standard Deviation 57.6190
142.476 mmol
Standard Deviation 59.1617
144.839 mmol
Standard Deviation 63.6708
140.887 mmol
Standard Deviation 68.4341
Urine Sodium and Potassium Excretion Per Treatment at 12 Hours Postdose
Potassium excretion
45.013 mmol
Standard Deviation 17.3416
37.827 mmol
Standard Deviation 16.0087
46.770 mmol
Standard Deviation 17.4395
44.137 mmol
Standard Deviation 11.0631

SECONDARY outcome

Timeframe: 24 hours postdose

Population: All patients who received at least one dose of study drug and had evaluable pharmacodynamics (PD)data with no major protocol deviation in at least one period were included in the PD analysis set.

Urine was collected 24 hours postdose in all treatment groups for sodium and potassium analysis. Each patient was required to void their bladder before drug administration and at the end 24 hours.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=31 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=31 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=30 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
n=28 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Urine Sodium and Potassium Excretion Per Treatment at 24 Hours Postdose
Sodium excretion
185.426 mmol
Standard Deviation 69.9537
187.256 mmol
Standard Deviation 69.1028
188.886 mmol
Standard Deviation 73.8708
192.176 mmol
Standard Deviation 76.0983
Urine Sodium and Potassium Excretion Per Treatment at 24 Hours Postdose
Potassium excretion
57.323 mmol
Standard Deviation 20.0607
53.107 mmol
Standard Deviation 21.3416
62.715 mmol
Standard Deviation 20.4014
61.012 mmol
Standard Deviation 13.6072

SECONDARY outcome

Timeframe: 0.5 hour pre-dose, 0.5, 1, 2, 4, 8, 12 and 24 hours post dose.

Population: Safety analysis set include subjects that received study drug.

Sitting blood pressure was measured three times at 1 to 2-minute intervals. The mean of the three sitting blood pressure measurements was used as the average of the sitting office blood pressure. The msSBP and msDBP data were analyzed using a mixed effect model with fixed effects from treatment and treatment\*time; random effect from patients and predose as covariate.

Outcome measures

Outcome measures
Measure
Furosemide 60 mg + Aliskiren Placebo
n=37 Participants
Patient received 60 mg furosemide at steady state + placebo to aliskiren from day 1 to day 7.
Furosemide 60 mg+ Single Dose Aliskiren 150mg
n=35 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg on day 8.
Furosemide 60 mg + Multiple Dose Aliskiren 150mg
n=32 Participants
Patient received 60 mg furosemide at steady state + single dose aliskiren 150mg ( day 9 - day 17).
Furosemide 60 mg + Multiple Dose Aliskiren 300mg
Patient received 60 mg furosemide at steady state + single dose aliskiren 300mg ( day 18 - day 27).
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
0.5 hour Postdose (msSBP)
114.78 mmHg
Standard Error 1.64
113.19 mmHg
Standard Error 1.70
114.31 mmHg
Standard Error 1.80
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
4 hour Postdose (msSBP)
106.50 mmHg
Standard Error 1.64
101.84 mmHg
Standard Error 1.70
101.06 mmHg
Standard Error 1.80
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
0.5 predose (msSBP)
118.26 mmHg
Standard Error 1.62
117.09 mmHg
Standard Error 1.70
116.63 mmHg
Standard Error 1.80
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
0.5 hour predose (msDBP)
71.70 mmHg
Standard Error 0.98
71.41 mmHg
Standard Error 1.04
71.39 mmHg
Standard Error 1.10
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
0.5 hour Postdose (msDBP)
70.94 mmHg
Standard Error 1.00
69.04 mmHg
Standard Error 1.04
69.86 mmHg
Standard Error 1.10
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
1 hour Postdose (msSBP)
115.15 mmHg
Standard Error 1.64
112.22 mmHg
Standard Error 1.70
112.16 mmHg
Standard Error 1.80
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
1 hour Postdose (msDBP)
71.22 mmHg
Standard Error 1.00
69.04 mmHg
Standard Error 1.04
68.96 mmHg
Standard Error 1.10
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
2 hour Postdose (msSBP)
113.61 mmHg
Standard Error 1.64
109.22 mmHg
Standard Error 1.70
109.63 mmHg
Standard Error 1.80
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
2 hour Postdose (msDBP)
68.39 mmHg
Standard Error 1.10
67.50 mmHg
Standard Error 1.04
68.39 mmHg
Standard Error 1.10
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
4 hour Postdose (msDBP)
63.85 mmHg
Standard Error 1.00
62.32 mmHg
Standard Error 1.04
59.07 mmHg
Standard Error 1.10
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
8 hour Postdose (msSBP)
110.75 mmHg
Standard Error 1.66
112.09 mmHg
Standard Error 1.70
109.95 mmHg
Standard Error 1.80
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
8 hour Postdose (msDBP)
66.33 mmHg
Standard Error 1.01
66.94 mmHg
Standard Error 1.04
66.46 mmHg
Standard Error 1.10
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
12 hour Postdose (msSBP)
116.99 mmHg
Standard Error 1.66
116.90 mmHg
Standard Error 1.70
115.16 mmHg
Standard Error 1.80
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
12 hour Postdose (msdBP)
67.86 mmHg
Standard Error 1.01
68.79 mmHg
Standard Error 1.04
68.50 mmHg
Standard Error 1.10
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
24 hour Postdose (msSBP)
115.49 mmHg
Standard Error 1.66
116.69 mmHg
Standard Error 1.72
118.41 mmHg
Standard Error 1.80
Mean Sitting Systolic Blood Pressure (msSBP)and Mean Sitting Diastolic Blood Pressure (msDBP)
24 hour Postdose (msDBP)
71.24 mmHg
Standard Error 1.01
71.66 mmHg
Standard Error 1.05
72.32 mmHg
Standard Error 1.10

Adverse Events

60 mg Furosemide + 150 mg Placebo + 300 mg Placebo

Serious events: 2 serious events
Other events: 0 other events
Deaths: 0 deaths

60 mg Furosemide + 150 mg Aliskiren + 300 mg Placebo

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

60 mg Furosemide + 300 mg Aliskiren + 150 mg Placebo

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

Serious adverse events

Serious adverse events
Measure
60 mg Furosemide + 150 mg Placebo + 300 mg Placebo
n=37 participants at risk
60 mg furosemide + 150 mg placebo + 300 mg placebo
60 mg Furosemide + 150 mg Aliskiren + 300 mg Placebo
n=33 participants at risk
60 mg furosemide + 150 mg aliskiren + 300 mg placebo
60 mg Furosemide + 300 mg Aliskiren + 150 mg Placebo
n=31 participants at risk
60 mg furosemide + 300 mg aliskiren + 150 mg placebo
Injury, poisoning and procedural complications
Rib fracture
2.7%
1/37
0.00%
0/33
0.00%
0/31
Metabolism and nutrition disorders
Gout
2.7%
1/37
0.00%
0/33
0.00%
0/31
Respiratory, thoracic and mediastinal disorders
Haemothorax
2.7%
1/37
0.00%
0/33
0.00%
0/31
Respiratory, thoracic and mediastinal disorders
Pneumothorax
2.7%
1/37
0.00%
0/33
0.00%
0/31

Other adverse events

Adverse event data not reported

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 or disclosure of trial results in their entirety.
  • Publication restrictions are in place

Restriction type: OTHER