Trial Outcomes & Findings for Nebivolol Effect on Nitric Oxide Levels, Blood Pressure, and Renal Function in Kidney Transplant Patients (NCT NCT01157234)

NCT ID: NCT01157234

Last Updated: 2024-11-06

Results Overview

Percent change in Nitric Oxide (NO) blood level (nmol/L)=\[Month-12 NO blood level minus baseline NO blood level\] divided by \[baseline NO blood level\] multiplied by 100, where all levels are in nmol/L.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

32 participants

Primary outcome timeframe

Change in Baseline, Month-12

Results posted on

2024-11-06

Participant Flow

The trial was conducted at the University of Florida and Shands Renal Transplant Clinic. The first patient was randomized on July 8, 2010 and the follow up of the last patient ended on July 21, 2014.

32 participants were screened, 2 failed screening and 30 met the eligibility criteria and randomized to either the arm with nebivolol or the arm with metoprolol.

Participant milestones

Participant milestones
Measure
Nebivolol
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Overall Study
STARTED
15
15
Overall Study
COMPLETED
14
15
Overall Study
NOT COMPLETED
1
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Nebivolol
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Overall Study
Withdrawal by Subject
1
0

Baseline Characteristics

Nebivolol Effect on Nitric Oxide Levels, Blood Pressure, and Renal Function in Kidney Transplant Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Nebivolol
n=15 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=15 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Total
n=30 Participants
Total of all reporting groups
Age, Continuous
53 years
STANDARD_DEVIATION 15.9 • n=5 Participants
46.4 years
STANDARD_DEVIATION 13.8 • n=7 Participants
49.7 years
STANDARD_DEVIATION 14.8 • n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
4 Participants
n=7 Participants
9 Participants
n=5 Participants
Sex: Female, Male
Male
10 Participants
n=5 Participants
11 Participants
n=7 Participants
21 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
8 Participants
n=5 Participants
5 Participants
n=7 Participants
13 Participants
n=5 Participants
Race (NIH/OMB)
White
7 Participants
n=5 Participants
10 Participants
n=7 Participants
17 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
15 participants
n=5 Participants
15 participants
n=7 Participants
30 participants
n=5 Participants
Plasma Nitric Oxide
52.93 nmol/l
STANDARD_DEVIATION 21.09 • n=5 Participants
48.23 nmol/l
STANDARD_DEVIATION 15.37 • n=7 Participants
50.53 nmol/l
STANDARD_DEVIATION 17.99 • n=5 Participants
Estimated Glomerular Filtration Rate
53.13 milliliter/minute
STANDARD_DEVIATION 14.15 • n=5 Participants
54.47 milliliter/minute
STANDARD_DEVIATION 14.65 • n=7 Participants
53.80 milliliter/minute
STANDARD_DEVIATION 13.67 • n=5 Participants
Systolic Blood Pressure
132.93 millimeter, mercury
STANDARD_DEVIATION 15.79 • n=5 Participants
131.33 millimeter, mercury
STANDARD_DEVIATION 18.14 • n=7 Participants
132.13 millimeter, mercury
STANDARD_DEVIATION 16.73 • n=5 Participants
Diastolic Blood Pressure
84.07 millimeter, mercury
STANDARD_DEVIATION 8.59 • n=5 Participants
86.33 millimeter, mercury
STANDARD_DEVIATION 8.62 • n=7 Participants
85.20 millimeter, mercury
STANDARD_DEVIATION 8.53 • n=5 Participants
Mean Arterial Blood Pressure
100.20 millimeter, mercury
STANDARD_DEVIATION 8.06 • n=5 Participants
101.47 millimeter, mercury
STANDARD_DEVIATION 10.76 • n=7 Participants
100.83 millimeter, mercury
STANDARD_DEVIATION 9.36 • n=5 Participants
Number of Antihypertensive Drug Classes Being Used
2.00 Antihypertensive Drug Classes
STANDARD_DEVIATION 0.84 • n=5 Participants
1.80 Antihypertensive Drug Classes
STANDARD_DEVIATION 0.68 • n=7 Participants
1.90 Antihypertensive Drug Classes
STANDARD_DEVIATION 0.89 • n=5 Participants

PRIMARY outcome

Timeframe: Change in Baseline, Month-12

Population: Full analysis set included all participants who signed informed consent and received at least one dose of study drug.

Percent change in Nitric Oxide (NO) blood level (nmol/L)=\[Month-12 NO blood level minus baseline NO blood level\] divided by \[baseline NO blood level\] multiplied by 100, where all levels are in nmol/L.

Outcome measures

Outcome measures
Measure
Nebivolol
n=15 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=15 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Plasma Nitric Oxide Level Change From Baseline to Month 12 Between the Groups.
11.47 percent change
Standard Error 9.20
-17.27 percent change
Standard Error 9.20

SECONDARY outcome

Timeframe: Change in Baseline, Month-12

Population: Full analysis set included all participants who signed inform consent and received at least one dose of study drug.

The changed percentage in Estimated Glomerular Filtration Rate (eGFR), (based on the Modification of Diet in Renal Disease Equation)=\[Month-12 GFR level minus baseline eGFR level\] divided by \[baseline eGFR level\] multiplied by 100, where all levels are in ml/min.

Outcome measures

Outcome measures
Measure
Nebivolol
n=15 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=15 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Estimated Glomerular Filtration Rate (ml/Minute) Change From Baseline to Month-12 Between the Groups
2.16 percent change
Standard Error 7.16
10.43 percent change
Standard Error 7.16

SECONDARY outcome

Timeframe: Change in Baseline, Month-12

Population: Full analysis set included all participants who signed inform consent and received at least one dose of study drug.

Absolute change in Systolic Blood Pressure (SBP), (millimeter, Mercury)=Month-12 sitting trough SBP level minus baseline sitting trough SBP level

Outcome measures

Outcome measures
Measure
Nebivolol
n=15 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=15 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Systolic Blood Pressure (Millimeter, Mercury) Change From Baseline to Month-12 of Treatment Between the Groups
-2.65 millimeter, Mercury
Standard Error 2.73
-3.88 millimeter, Mercury
Standard Error 2.73

SECONDARY outcome

Timeframe: Change in Baseline, Month-12

Population: Full analysis set included all participants who signed inform consent and received at least one dose of study drug.

Absolute Change in Diastolic Blood Pressure (DBP), (millimeter, Mercury)= Month-12 sitting trough Diastolic Blood Pressure (millimeter, Mercury) level minus baseline sitting trough Diastolic Blood Pressure (millimeter, Mercury).

Outcome measures

Outcome measures
Measure
Nebivolol
n=15 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=15 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Diastolic Blood Pressure (Millimeter, Mercury) Change From Baseline to Month-12 Between the Groups
-0.66 millimeter, mercury
Standard Error 1.91
-2.35 millimeter, mercury
Standard Error 1.91

SECONDARY outcome

Timeframe: Change in Baseline, Month-12

Population: Full analysis set included all participants who signed inform consent and received at least one dose of study drug.

Absolute change in Mean Arterial Blood Pressure, (MAP), (millimeter, Mercury= Month-12 sitting trough MAP minus baseline sitting trough MAP. Mean Arterial Pressure= 2/3 trough diastolic blood pressure + 1/3 trough systolic blood pressure

Outcome measures

Outcome measures
Measure
Nebivolol
n=15 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=15 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Mean Arterial Blood Pressure (Millimeter, Mercury) Change From Baseline to Month-12 Between the Groups
-1.07 millimeter, Mercury
Standard Error 2.11
-3.19 millimeter, Mercury
Standard Error 2.11

SECONDARY outcome

Timeframe: Change in Baseline, Month-12

Population: Percent change

Percent change in quantity of Anti-Hypertensive Drug Classes (AHDC)=\[Month-12 absolute number of AHDC minus baseline absolute number of AHDC\] divided by \[baseline absolute number of AHDC\] multiplied by 100.

Outcome measures

Outcome measures
Measure
Nebivolol
n=15 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=15 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Number of Antihypertensive Drug Classes Change From Baseline to Month-12 Between the Groups.
-8.14 percent change
Standard Error 11.58
8.70 percent change
Standard Error 11.58

SECONDARY outcome

Timeframe: Baseline, Month-12

Population: Technical limitations constrained measurements of Asymmetric Dimethylarginine (ADMA), resulting in no analysis for this outcome.

Percent change in plasma ADMA (umol/L)=\[month-12 plasma ADMA level minus baseline plasma ADMA level\] divided by \[baseline plasma ADMA level\] multiplied by 100, where all levels are in umol/L.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline, Month-12

Population: Technical limitations constrained measurements of plasma Arginine, resulting in no analysis for this outcome.

Percent change in plasma Arginine (umol/L)=\[month-12 plasma Arginine level minus baseline plasma Arginine level\] divided by \[baseline plasma Arginine level\] multiplied by 100, where all levels are in umol/L

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 12 Months

Population: Full analysis set included all participants who signed inform consent and received at least one dose of study drug

Outcome measures

Outcome measures
Measure
Nebivolol
n=15 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=15 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Plasma Nitric Oxide Level (Nmol/L) at Month-12 Between the Groups.
50.07 nmol/L
Standard Error 3.93
38.13 nmol/L
Standard Error 3.93

POST_HOC outcome

Timeframe: Baseline and Month-12

Population: Nebivolol and metoprolol groups were subdivided into \<50 years old and \>50 years old subgroups and differences between subgroups were analyzed.

Outcome measures

Outcome measures
Measure
Nebivolol
n=6 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=7 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Percent Change in Plasma Nitric Oxide Level From Baseline to Month-12 of Treatment With Nebivolol in Transplant Recipients <50 Years Old Compared With Metoprolol in Transplant Recipients >/= 50 Years Old.
51.55 percent change
Standard Error 14.55
-17.99 percent change
Standard Error 13.47

POST_HOC outcome

Timeframe: Change in Baseline, Month-12

Population: Nebivolol and metoprolol groups were subdivided into \<50 years old and \>50 years old subgroups and differences between subgroups were analyzed.

Outcome measures

Outcome measures
Measure
Nebivolol
n=6 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=8 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Percent Change in Plasma Nitric Oxide Level From Baseline to Month-12 of Treatment With Nebivolol in Transplant Recipients < 50 Years Old Compared With Metoprolol in Transplant Recipients < 50 Years Old
51.55 percent change
Standard Error 14.55
-16.64 percent change
Standard Error 12.60

POST_HOC outcome

Timeframe: Change in Baseline, Month-12

Population: Nebivolol and metoprolol groups were subdivided into \<50 years old and \>50 years old subgroups and differences between subgroups were analyzed.

Outcome measures

Outcome measures
Measure
Nebivolol
n=9 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=8 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Percent Change in Plasma Nitric Oxide Level From Baseline to Month-twelve of Treatment With Nebivolol in Transplant Recipients >/= 50 Years Old Compared With Nebivolol in Transplant Recipients < 50 Years Old.
-15.25 percent change
Standard Error 11.88
-16.64 percent change
Standard Error 12.60

POST_HOC outcome

Timeframe: Change in Baseline, Month-12

Outcome measures

Outcome measures
Measure
Nebivolol
n=9 Participants
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Metoprolol
n=7 Participants
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study.
Percent Change in Plasma Nitric Oxide Level From Baseline to Month-12 of Treatment With Nebivolol in Transplant Recipients >/= 50 Years Old Compared With Metoprolol in Transplant Recipients Age >/= 50 Years Old.
-15.25 percent change
Standard Error 11.88
-17.99 percent change
Standard Error 13.47

Adverse Events

Nebivolol

Serious events: 4 serious events
Other events: 9 other events
Deaths: 0 deaths

Metoprolol

Serious events: 5 serious events
Other events: 13 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Nebivolol
n=15 participants at risk
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study. Nebivolol: Nebivolol 5 mg once daily, titrated to a maximum total daily dose of 40 mg to achieve a blood pressure of \< 140/ 90.
Metoprolol
n=15 participants at risk
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study. Metoprolol: Metoprolol 25 mg twice daily, titrated to a maximum total daily dose of 400 mg to achieve a blood pressure \< 140/90.
Infections and infestations
Urinary Tract Infection
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
Injury, poisoning and procedural complications
Abdominal Hematoma
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
Renal and urinary disorders
Renal Insufficiency
13.3%
2/15 • 4 years
6.7%
1/15 • 4 years
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Prostate Cancer
0.00%
0/15 • 4 years
6.7%
1/15 • 4 years
Surgical and medical procedures
Herniorraphy
0.00%
0/15 • 4 years
6.7%
1/15 • 4 years
Gastrointestinal disorders
Vomiting
0.00%
0/15 • 4 years
6.7%
1/15 • 4 years
Infections and infestations
Cytomegalovirus Infection
0.00%
0/15 • 4 years
6.7%
1/15 • 4 years

Other adverse events

Other adverse events
Measure
Nebivolol
n=15 participants at risk
Nebivolol starting dose of 5 mg orally once daily, titrated to a maximum total daily dose of 40 mg daily to achieve a target blood pressure of \<140/90 and continued until month-12 of the study. Nebivolol: Nebivolol 5 mg once daily, titrated to a maximum total daily dose of 40 mg to achieve a blood pressure of \< 140/ 90.
Metoprolol
n=15 participants at risk
Metoprolol starting dose of 25mg orally once twice daily, titrated to a maximum total daily dose of 400 mg to achieve a target blood pressure of \<140/90 and continued until month-12 of the study. Metoprolol: Metoprolol 25 mg twice daily, titrated to a maximum total daily dose of 400 mg to achieve a blood pressure \< 140/90.
Blood and lymphatic system disorders
leukopenia
0.00%
0/15 • 4 years
6.7%
1/15 • 4 years
Endocrine disorders
hyperglycemia
13.3%
2/15 • 4 years
20.0%
3/15 • 4 years
Ear and labyrinth disorders
Earache
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
Eye disorders
Eye Irritation
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
Gastrointestinal disorders
Abdominal Pain
6.7%
1/15 • 4 years
6.7%
1/15 • 4 years
Gastrointestinal disorders
Constipation
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
Gastrointestinal disorders
Diarrhea
26.7%
4/15 • 4 years
13.3%
2/15 • 4 years
Gastrointestinal disorders
Dyspepsia
0.00%
0/15 • 4 years
6.7%
1/15 • 4 years
Gastrointestinal disorders
Nausea
13.3%
2/15 • 4 years
6.7%
1/15 • 4 years
Gastrointestinal disorders
Vomiting
13.3%
2/15 • 4 years
0.00%
0/15 • 4 years
General disorders
Chest Pain
6.7%
1/15 • 4 years
6.7%
1/15 • 4 years
General disorders
Edema
6.7%
1/15 • 4 years
6.7%
1/15 • 4 years
General disorders
Fatigue
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
General disorders
Influenza-like Illness
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
Infections and infestations
Cytomegalovirus Infection
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
Infections and infestations
Urinary Tract Infection
13.3%
2/15 • 4 years
20.0%
3/15 • 4 years
Musculoskeletal and connective tissue disorders
Arm Pain
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
Musculoskeletal and connective tissue disorders
Low Back Pain
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
Nervous system disorders
Dizziness
0.00%
0/15 • 4 years
6.7%
1/15 • 4 years
Nervous system disorders
Headache
13.3%
2/15 • 4 years
13.3%
2/15 • 4 years
Psychiatric disorders
Anxiety
0.00%
0/15 • 4 years
6.7%
1/15 • 4 years
Reproductive system and breast disorders
Hydrocele
0.00%
0/15 • 4 years
6.7%
1/15 • 4 years
Respiratory, thoracic and mediastinal disorders
Cough
26.7%
4/15 • 4 years
13.3%
2/15 • 4 years
Respiratory, thoracic and mediastinal disorders
Dyspnea
6.7%
1/15 • 4 years
0.00%
0/15 • 4 years
Respiratory, thoracic and mediastinal disorders
Nasal Congestion
20.0%
3/15 • 4 years
20.0%
3/15 • 4 years
Respiratory, thoracic and mediastinal disorders
Oropharyngeal Pain
0.00%
0/15 • 4 years
6.7%
1/15 • 4 years

Additional Information

Alfonso H. Santos Jr, M,D,

University of Florida

Phone: 352-273-6374

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: OTHER