24 Week Efficacy and Safety Study of Empagliflozin (BI 10773) in Hypertensive Black/African American Patients With Type 2 Diabetes Mellitus and Hypertension
NCT ID: NCT02182830
Last Updated: 2018-07-31
Study Results
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View full resultsBasic Information
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COMPLETED
PHASE3
166 participants
INTERVENTIONAL
2014-07-25
2017-05-18
Brief Summary
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Essential hypertension is four times more common in African Americans than in Caucasians.
One of the risk factors for hypertension is sodium sensitivity and approximately one third of the essential hypertensive population is responsive to sodium intake. There is a higher association of hypertension with sodium sensitivity in African American patients with type 2 Diabetes Mellitus.
The treatment duration of this trial (24 weeks) will enable assessment of the clinically relevant endpoint of a decrease in HbA1c, a well accepted measurement of chronic glycaemic control and the key secondary endpoints of decreases in systolic BP (SBP) and diastolic BP (DBP) at 12 and 24 weeks.
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Study Groups
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Empagliflozin
starting dose 10mg; forced titration after 4 weeks 25mg dose
Empagliflozin low dose
starting dose 10mg; forced titration after 4 weeks 25mg dose
Empagliflozin high dose
starting dose 10mg; forced titration after 4 weeks 25mg dose
Placebo
starting dose 10mg; forced titration after 4 weeks 25mg dose
placebo
starting dose 10mg; forced titration after 4 weeks 25mg dose
Interventions
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Empagliflozin low dose
starting dose 10mg; forced titration after 4 weeks 25mg dose
placebo
starting dose 10mg; forced titration after 4 weeks 25mg dose
Empagliflozin high dose
starting dose 10mg; forced titration after 4 weeks 25mg dose
Eligibility Criteria
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Inclusion Criteria
* Male and female black/African American patients on diet and exercise regimen who are EITHER drug-naïve (defined as absence of any oral antidiabetic therapy, glucagon like peptide-1 (GLP-1) analog or insulin for 12 weeks, 16 weeks for pioglitazone prior to randomisation) OR pre-treated with stable dose of
* Metformin only, or
* Sulfonylurea only, or
* Dipeptidyl peptidase-4 (DPP-4) inhibitor only, or
* metformin plus sulfonylurea, or
* metformin plus DPP-4 inhibitor. Treatment has to be unchanged for a minimum of 12 weeks prior to randomization. Dose for metformin: maximum tolerated dose The maximum daily dose of Sulfonylurea (SU) or DPP-4 inhibitor should not exceed that stated in the local label.
* HbA1c of \>= 7.0% (53 mmol/mol) and ≤ 11.0% (97 mmol/mol) at Visit 1 (screening).
* Mean seated Systolic Blood Pressure (SBP) 140-180 mmHg at Visit 1 (screening).
* Successful completion of baseline Ambulatory Blood Pressure Monitor (ABPM) testing with a mean SBP 135-175 mmHg prior to randomisation.
* Treatment with stable doses of at least one but not more than 4 antihypertensive medication \>= 4 weeks prior to randomisation.
* Age \>= 18 years at Visit 1 (screening)
* Signed and dated written informed consent by date of Visit 1 in accordance with Good Clinical Practice (GCP) and local legislation
Exclusion Criteria
* Exposure to any other antidiabetic medication within 12 weeks prior to randomisation other than metformin, sulfonylurea, Dipeptidyl peptidase-4 (DPP-4) inhibitor, metformin plus sulfonylurea or metformin plus DPP-4 inhibitor.
* Current hypertension treatment with oral Minoxidil (topical minoxidil for hair growth is allowed).
* Mean seated Systolic Blood Pressure (SBP) ≥181 mmHg during placebo run-in visit and confirmed by a second measurement (not on the same day) preferably within one day.
* Upper arm circumference that exceeds the upper circumference level of the cuff size of either Ambulatory Blood Pressure Monitor (ABPM) and/or (BP) measurement device used in the study.
* Night shift workers who routinely sleep during the daytime and/or whose work hours include midnight.
* Diagnosis of autoimmune diabetes/Type I diabetes mellitus, monogenic (neonatal or maturity onset diabetes of the young (MODY)) diabetes or Type I diabetes in adults/latent autoimmune diabetes of adults (LADA) per investigator or patient medical history at the time of Visit 1 (screening).
* Known or suspected secondary hypertension (e.g. renal artery stenosis,phaeochromocytoma, Cushing's disease).
* History or evidence of hypertensive retinopathy (Keith-Wagener grade III or IV) and/or hypertensive encephalopathy.
* Clinically significant valvular heart disease or severe aortic stenosis in the opinion of the investigator.
* Acute coronary syndrome (non- ST wave elevated myocardial infarction (STEMI), STEMI and unstable angina pectoris), stroke or transient ischemic attack within 3 months prior to informed consent.
* Indication of liver disease, defined by serum levels of either Alanine Aminotransferase (ALT) (Serum Glutamic Pyruvate Transaminase(SGPT)), Aspartate Aminotransferase (AST) (Serum Glutamic Oxaloacetic Transaminase (SGOT)), or alkaline phosphatase above 3 x upper limit of normal (ULN) as determined during screening and/or run-in phase.
* Impaired renal function, defined as Estimated Glomerular Filtration Rate (eGFR)\< 45 ml/min/1.73m2 (moderate renal impairment, chronic kidney disease epidemiology collaboration Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula) as determined during screening and/or run-in phase.
* Bariatric surgery within the past two years and other gastrointestinal surgeries that induce chronic malabsorption.
* Medical history of cancer (except for basal cell carcinoma) and/or treatment for cancer within the last 5 years.
* Blood dyscrasias or any disorders causing hemolysis or unstable Red Blood Cells (e.g. malaria, babesiosis, haemolytic anaemia, thalassemia, sickle cell anaemia (sickle cell trait is allowed)).
* Medical history and signs and symptoms of diabetic autonomic neuropathy.
* Treatment with anti-obesity drugs 3 months prior to randomisation (i.e. surgery, aggressive diet regimen, etc.) leading to unstable body weight.
* Current treatment with systemic steroids at time of informed consent or change in dosage of thyroid hormones within 6 weeks prior to informed consent or any other uncontrolled endocrine disorder except Type 2 Diabetes Mellitus (T2DM) in the opinion of the investigator.
* Pre-menopausal women (last menstruation \<=1 year prior to informed consent) who:
* are nursing or pregnant or
* are of child-bearing potential and are not practicing an acceptable method of birth control, or do not plan to continue using this method throughout the study and do not agree to submit to periodic pregnancy testing during participation in the trial. Acceptable methods of birth control include tubal ligation, transdermal patch, intra uterine devices/systems (IUDs/IUSs), oral, implantable or injectable contraceptives, complete sexual abstinence (if acceptable by local authorities), double barrier method and vasectomised partner.
* Alcohol, drug or confectionary liquorice abuse within the 3 months prior to informed consent that would interfere with trial participation or any ongoing condition leading to a decreased compliance to study procedures or study drug intake in the investigator's opinion.
* Intake of an investigational drug in another trial within 30 days prior to intake of study medication in this trial; or participating in another trial (involving an investigational drug and/or follow-up) after discontinuing medication in that trial.
* Any other clinical condition that would jeopardize patient's safety while participating in this clinical trial in the opinion of the investigator.
18 Years
ALL
No
Sponsors
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Eli Lilly and Company
INDUSTRY
Boehringer Ingelheim
INDUSTRY
Responsible Party
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Principal Investigators
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Boehringer Ingelheim
Role: STUDY_CHAIR
Boehringer Ingelheim
Locations
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University of Alabama at Birmingham
Birmingham, Alabama, United States
Clinical Research Advantage, Inc./Rita B. Chuang, MD, LLC
Birmingham, Alabama, United States
Longwood Research
Huntsville, Alabama, United States
Internal Medicine Center, LLC
Mobile, Alabama, United States
Mobile Medical and Diagnostic Center
Mobile, Alabama, United States
University of South Alabama
Mobile, Alabama, United States
Cardiology and Medicine Clinic
Little Rock, Arkansas, United States
Larry Watkins, M .D.
Little Rock, Arkansas, United States
eStudySite
Chula Vista, California, United States
Torrance Clinical Research Institute Inc.
Lomita, California, United States
Long Beach Center for Clinical Research
Long Beach, California, United States
MD Clinical Trials
Los Angeles, California, United States
Office of Dr. Alexander Ford, M.D.
Los Angeles, California, United States
Diabetes Associates Medical Group
Orange, California, United States
Integrated Research Group, Inc.
Riverside, California, United States
Clinical Trials Research
Sacramento, California, United States
Orange County Research Center
Tustin, California, United States
Lynn Institute of Denver
Denver, Colorado, United States
Pines Clinical Research Inc.
Hollywood, Florida, United States
UF Health Jacksonville
Jacksonville, Florida, United States
Care Partners Clinical Research LLC
Jacksonville, Florida, United States
Sunshine Research Center
Opa-locka, Florida, United States
Central Florida Internist
Orlando, Florida, United States
Accord Clinical Research, LLC
Port Orange, Florida, United States
International Clinical Research - US, LLC
Sanford, Florida, United States
Meridien Research
St. Petersburg, Florida, United States
Alternative Solutions Medical Research and Prevention Center
St. Petersburg, Florida, United States
Meridien Research
Tampa, Florida, United States
Grady Memorial Hospital
Atlanta, Georgia, United States
Morehouse School of Medicine
Atlanta, Georgia, United States
Atlanta Center
Atlanta, Georgia, United States
Atlanta Clinical Research Centers
Atlanta, Georgia, United States
Albert F. Johary MD, PC
Dunwoody, Georgia, United States
Sestron Clinical Research
Marietta, Georgia, United States
Clinical Research Advantage, Inc./Rita B. Chuang, MD, LLC
Marietta, Georgia, United States
WR-Mount Vernon Clinical Research, LLC
Sandy Springs, Georgia, United States
Eagle's Landing Diabetes and Endocrinology
Stockbridge, Georgia, United States
Cedar Crosse Research Center
Chicago, Illinois, United States
John H. Stroger Jr. Hospital of Cook Country
Chicago, Illinois, United States
University of Chicago
Chicago, Illinois, United States
Investigators Research Group, LLC
Brownsburg, Indiana, United States
Centex Studies, Inc.
Lake Charles, Louisiana, United States
Gulf Regional Research and Education Services, LLC
Metairie, Louisiana, United States
New Orleans Center for Clinical Research
New Orleans, Louisiana, United States
University of Maryland School of Medicine
Baltimore, Maryland, United States
American Institute of Research Studies
Baltimore, Maryland, United States
Phillips Medical Services, PLLC
Jackson, Mississippi, United States
Mercy Research
Washington, Missouri, United States
Quality Clinical Research Inc
Omaha, Nebraska, United States
Accent Clinical Trials
Las Vegas, Nevada, United States
Lovelace Scientific Resources, Inc.
Albuquerque, New Mexico, United States
Offic of Dr. Eric Cheng
Brooklyn, New York, United States
Healthwise Medical Associates
Brooklyn, New York, United States
Modern Medical
Brooklyn, New York, United States
Erie County Medical Center
Buffalo, New York, United States
Scott Research, Inc.
Laurelton, New York, United States
Medex Healthcare Research, Inc.
New York, New York, United States
Laurelton Heart Specialist, PC
Rosedale, New York, United States
Metrolina Internal Medicine, PA
Charlotte, North Carolina, United States
PhysiqueMed Clinical Trials
Greensboro, North Carolina, United States
Triad Clinical Trials
Greensboro, North Carolina, United States
Peters Medical Research
High Point, North Carolina, United States
High Point Clinical Trials Center
High Point, North Carolina, United States
Coastal Carolina Health Care, P.A.
New Bern, North Carolina, United States
Hometown Urgent Care
Columbus, Ohio, United States
Dayton Clinical Research
Dayton, Ohio, United States
Today Clinical Research, Oklahoma City
Oklahoma City, Oklahoma, United States
Suburban Research Associates
Media, Pennsylvania, United States
Temple University School of Medicine
Philadelphia, Pennsylvania, United States
Medical Research South
Charleston, South Carolina, United States
TLM Medical Services, LLC
Columbia, South Carolina, United States
Amistad Clinical Research Center
Columbia, South Carolina, United States
Greenville Pharmaceutical Rsch
Greenville, South Carolina, United States
Mountain View Clinical Research
Greer, South Carolina, United States
Berkley Family Practice
Moncks Corner, South Carolina, United States
Carolina Cardiology Clinical Research Institute, LLC
Rock Hill, South Carolina, United States
Community Research Partners, Inc
Varnville, South Carolina, United States
Memphis Veterans Affairs Medical Center
Memphis, Tennessee, United States
The Green Clinic PC
Memphis, Tennessee, United States
Southwind Medical Specialists
Memphis, Tennessee, United States
University of Tennessee
Memphis, Tennessee, United States
Diagnostic Clinic of Houston
Houston, Texas, United States
Cullen Family Practice, PLLC
Houston, Texas, United States
Centex Studies, Inc.
Houston, Texas, United States
Texas Center for Drug Development, Inc.
Houston, Texas, United States
Kelsey-Seybold Clinic
Houston, Texas, United States
Hillcrest Family Health Center
Waco, Texas, United States
Millennium Clinical Trials LLC
Arlington, Virginia, United States
York Clinical Research, LLC
Norfolk, Virginia, United States
Dominion Medical Associates, Inc.
Richmond, Virginia, United States
Clinical Research Partners, LLC
Richmond, Virginia, United States
Family Medical Clinic
Milwaukee, Wisconsin, United States
Countries
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References
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Ferdinand KC, Harrison D, Johnson A. The NEW-HOPE study and emerging therapies for difficult-to-control and resistant hypertension. Prog Cardiovasc Dis. 2020 Jan-Feb;63(1):64-73. doi: 10.1016/j.pcad.2019.12.008. Epub 2020 Jan 8.
Ferdinand KC, Izzo JL, Lee J, Meng L, George J, Salsali A, Seman L. Antihyperglycemic and Blood Pressure Effects of Empagliflozin in Black Patients With Type 2 Diabetes Mellitus and Hypertension. Circulation. 2019 Apr 30;139(18):2098-2109. doi: 10.1161/CIRCULATIONAHA.118.036568.
Ferdinand KC, Seman L, Salsali A. Design of a 24-week trial of empagliflozin once daily in hypertensive black/African American patients with type 2 diabetes mellitus. Curr Med Res Opin. 2018 Feb;34(2):361-367. doi: 10.1080/03007995.2017.1405800. Epub 2017 Nov 29.
Provided Documents
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Document Type: Study Protocol
Document Type: Statistical Analysis Plan
Other Identifiers
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1245.29
Identifier Type: -
Identifier Source: org_study_id
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