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

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

166 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-07-25

Study Completion Date

2017-05-18

Brief Summary

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This trial is designed to investigate the efficacy and safety of empagliflozin compared with placebo in hypertensive black/African Americans with type 2 Diabetes Mellitus. Since hyperglycaemia and hypertension are key risk factors for both micro- and macrovascular complications, assessment of both glucose and BP lowering effects of empagliflozin in hypertensive African American patients with type 2 Diabetes Mellitus could provide clinically highly relevant, new information for the use of empagliflozin.

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.

Detailed Description

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Conditions

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Diabetes Mellitus, Type 2 Hypertension

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Study Groups

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Empagliflozin

starting dose 10mg; forced titration after 4 weeks 25mg dose

Group Type EXPERIMENTAL

Empagliflozin low dose

Intervention Type DRUG

starting dose 10mg; forced titration after 4 weeks 25mg dose

Empagliflozin high dose

Intervention Type DRUG

starting dose 10mg; forced titration after 4 weeks 25mg dose

Placebo

starting dose 10mg; forced titration after 4 weeks 25mg dose

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

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

Intervention Type DRUG

placebo

starting dose 10mg; forced titration after 4 weeks 25mg dose

Intervention Type DRUG

Empagliflozin high dose

starting dose 10mg; forced titration after 4 weeks 25mg dose

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of Type 2 Diabetes Mellitus (T2DM) prior to informed consent.
* 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

* Uncontrolled hyperglycemia with a glucose level \>270 mg/dl (\>15.0 mmol/L) after an overnight fast during placebo run-in (includes Visit 2.1) and confirmed by a second measurement (not on the same day).
* 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.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eli Lilly and Company

INDUSTRY

Sponsor Role collaborator

Boehringer Ingelheim

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

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

Site Status

Clinical Research Advantage, Inc./Rita B. Chuang, MD, LLC

Birmingham, Alabama, United States

Site Status

Longwood Research

Huntsville, Alabama, United States

Site Status

Internal Medicine Center, LLC

Mobile, Alabama, United States

Site Status

Mobile Medical and Diagnostic Center

Mobile, Alabama, United States

Site Status

University of South Alabama

Mobile, Alabama, United States

Site Status

Cardiology and Medicine Clinic

Little Rock, Arkansas, United States

Site Status

Larry Watkins, M .D.

Little Rock, Arkansas, United States

Site Status

eStudySite

Chula Vista, California, United States

Site Status

Torrance Clinical Research Institute Inc.

Lomita, California, United States

Site Status

Long Beach Center for Clinical Research

Long Beach, California, United States

Site Status

MD Clinical Trials

Los Angeles, California, United States

Site Status

Office of Dr. Alexander Ford, M.D.

Los Angeles, California, United States

Site Status

Diabetes Associates Medical Group

Orange, California, United States

Site Status

Integrated Research Group, Inc.

Riverside, California, United States

Site Status

Clinical Trials Research

Sacramento, California, United States

Site Status

Orange County Research Center

Tustin, California, United States

Site Status

Lynn Institute of Denver

Denver, Colorado, United States

Site Status

Pines Clinical Research Inc.

Hollywood, Florida, United States

Site Status

UF Health Jacksonville

Jacksonville, Florida, United States

Site Status

Care Partners Clinical Research LLC

Jacksonville, Florida, United States

Site Status

Sunshine Research Center

Opa-locka, Florida, United States

Site Status

Central Florida Internist

Orlando, Florida, United States

Site Status

Accord Clinical Research, LLC

Port Orange, Florida, United States

Site Status

International Clinical Research - US, LLC

Sanford, Florida, United States

Site Status

Meridien Research

St. Petersburg, Florida, United States

Site Status

Alternative Solutions Medical Research and Prevention Center

St. Petersburg, Florida, United States

Site Status

Meridien Research

Tampa, Florida, United States

Site Status

Grady Memorial Hospital

Atlanta, Georgia, United States

Site Status

Morehouse School of Medicine

Atlanta, Georgia, United States

Site Status

Atlanta Center

Atlanta, Georgia, United States

Site Status

Atlanta Clinical Research Centers

Atlanta, Georgia, United States

Site Status

Albert F. Johary MD, PC

Dunwoody, Georgia, United States

Site Status

Sestron Clinical Research

Marietta, Georgia, United States

Site Status

Clinical Research Advantage, Inc./Rita B. Chuang, MD, LLC

Marietta, Georgia, United States

Site Status

WR-Mount Vernon Clinical Research, LLC

Sandy Springs, Georgia, United States

Site Status

Eagle's Landing Diabetes and Endocrinology

Stockbridge, Georgia, United States

Site Status

Cedar Crosse Research Center

Chicago, Illinois, United States

Site Status

John H. Stroger Jr. Hospital of Cook Country

Chicago, Illinois, United States

Site Status

University of Chicago

Chicago, Illinois, United States

Site Status

Investigators Research Group, LLC

Brownsburg, Indiana, United States

Site Status

Centex Studies, Inc.

Lake Charles, Louisiana, United States

Site Status

Gulf Regional Research and Education Services, LLC

Metairie, Louisiana, United States

Site Status

New Orleans Center for Clinical Research

New Orleans, Louisiana, United States

Site Status

University of Maryland School of Medicine

Baltimore, Maryland, United States

Site Status

American Institute of Research Studies

Baltimore, Maryland, United States

Site Status

Phillips Medical Services, PLLC

Jackson, Mississippi, United States

Site Status

Mercy Research

Washington, Missouri, United States

Site Status

Quality Clinical Research Inc

Omaha, Nebraska, United States

Site Status

Accent Clinical Trials

Las Vegas, Nevada, United States

Site Status

Lovelace Scientific Resources, Inc.

Albuquerque, New Mexico, United States

Site Status

Offic of Dr. Eric Cheng

Brooklyn, New York, United States

Site Status

Healthwise Medical Associates

Brooklyn, New York, United States

Site Status

Modern Medical

Brooklyn, New York, United States

Site Status

Erie County Medical Center

Buffalo, New York, United States

Site Status

Scott Research, Inc.

Laurelton, New York, United States

Site Status

Medex Healthcare Research, Inc.

New York, New York, United States

Site Status

Laurelton Heart Specialist, PC

Rosedale, New York, United States

Site Status

Metrolina Internal Medicine, PA

Charlotte, North Carolina, United States

Site Status

PhysiqueMed Clinical Trials

Greensboro, North Carolina, United States

Site Status

Triad Clinical Trials

Greensboro, North Carolina, United States

Site Status

Peters Medical Research

High Point, North Carolina, United States

Site Status

High Point Clinical Trials Center

High Point, North Carolina, United States

Site Status

Coastal Carolina Health Care, P.A.

New Bern, North Carolina, United States

Site Status

Hometown Urgent Care

Columbus, Ohio, United States

Site Status

Dayton Clinical Research

Dayton, Ohio, United States

Site Status

Today Clinical Research, Oklahoma City

Oklahoma City, Oklahoma, United States

Site Status

Suburban Research Associates

Media, Pennsylvania, United States

Site Status

Temple University School of Medicine

Philadelphia, Pennsylvania, United States

Site Status

Medical Research South

Charleston, South Carolina, United States

Site Status

TLM Medical Services, LLC

Columbia, South Carolina, United States

Site Status

Amistad Clinical Research Center

Columbia, South Carolina, United States

Site Status

Greenville Pharmaceutical Rsch

Greenville, South Carolina, United States

Site Status

Mountain View Clinical Research

Greer, South Carolina, United States

Site Status

Berkley Family Practice

Moncks Corner, South Carolina, United States

Site Status

Carolina Cardiology Clinical Research Institute, LLC

Rock Hill, South Carolina, United States

Site Status

Community Research Partners, Inc

Varnville, South Carolina, United States

Site Status

Memphis Veterans Affairs Medical Center

Memphis, Tennessee, United States

Site Status

The Green Clinic PC

Memphis, Tennessee, United States

Site Status

Southwind Medical Specialists

Memphis, Tennessee, United States

Site Status

University of Tennessee

Memphis, Tennessee, United States

Site Status

Diagnostic Clinic of Houston

Houston, Texas, United States

Site Status

Cullen Family Practice, PLLC

Houston, Texas, United States

Site Status

Centex Studies, Inc.

Houston, Texas, United States

Site Status

Texas Center for Drug Development, Inc.

Houston, Texas, United States

Site Status

Kelsey-Seybold Clinic

Houston, Texas, United States

Site Status

Hillcrest Family Health Center

Waco, Texas, United States

Site Status

Millennium Clinical Trials LLC

Arlington, Virginia, United States

Site Status

York Clinical Research, LLC

Norfolk, Virginia, United States

Site Status

Dominion Medical Associates, Inc.

Richmond, Virginia, United States

Site Status

Clinical Research Partners, LLC

Richmond, Virginia, United States

Site Status

Family Medical Clinic

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

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.

Reference Type DERIVED
PMID: 31923435 (View on PubMed)

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.

Reference Type DERIVED
PMID: 30786754 (View on PubMed)

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.

Reference Type DERIVED
PMID: 29139301 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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1245.29

Identifier Type: -

Identifier Source: org_study_id

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