Enalapril Maleate on Arterial Stiffness in Rheumatoid Arthritis.

NCT ID: NCT03667131

Last Updated: 2018-11-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

59 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-13

Study Completion Date

2018-02-19

Brief Summary

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This study evaluates the effect in artery stiffness of enalapril maleate in Rheumatoid Arthritis women patients. Half of participants will receive 5 mg enalapril maleate every 12 hrs, while the other half will receive a placebo.

Detailed Description

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Rheumatoid Arthritis (RA) is a chronic inflammatory systemic disease considered as an independent cardiovascular risk factor that is associated with cumulative inflammatory load with an elevation of circulating levels of cytokines, which mediate the mechanism of endothelial cells activation by increasing the angiotensin converting enzyme (ACE) function and generation of vasoconstriction. Enalapril maleate is a prodrug that is hydrolyzed by hepatic esterases in enalaprilat, which is a potent inhibitor of ACE. ACE inhibition decreases vascular systemic resistance and mean, diastolic and systolic blood pressures in several hypertensive states, independently of the mechanism, ACE inhibitors have a widespread clinic use for cardiovascular diseases. Therefore, the researchers considered that there could be an association between the use of enalapril and the decrease in arterial stiffness.

Conditions

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Rheumatoid Arthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized, double blind, controlled, parallel groups clinical trial.
Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Participant, care provider, investigator and outcomes assessor.

Study Groups

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Enalapril Maleate

Enalapril Maleate 5 mg every 12 hrs for 90 days.

Group Type EXPERIMENTAL

Enalapril Maleate

Intervention Type DRUG

Enalapril Maleate 5 mg tablet, every 12 hrs for 90 days.

Placebo

Substance that lacks in itself therapeutic action.

Group Type EXPERIMENTAL

Placebo

Intervention Type DRUG

Placebo 5 mg tablet, every 12 hrs for 90 days.

Interventions

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Enalapril Maleate

Enalapril Maleate 5 mg tablet, every 12 hrs for 90 days.

Intervention Type DRUG

Placebo

Placebo 5 mg tablet, every 12 hrs for 90 days.

Intervention Type DRUG

Other Intervention Names

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Angiotensin converting enzyme inhibitor. Inactive drug

Eligibility Criteria

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Inclusion Criteria

* Patients classified with RA according to the American College of Rheumatology (ACR) / European League Against Rheumatism (EULAR) 2010
* Patients treated in the outpatient service of the Rheumatology Service of the Hospital Civil de Guadalajara "Dr. Juan I Menchaca".
* Sign an Informed Consent Letter
* Under treatment with conventional Disease-Modifying Antirheumatic Drugs (DMARDS)

Exclusion Criteria

* Patients with a previous diagnosis of diabetes mellitus, systemic hypertension, thyroid, kidney or liver disease
* History of acute myocardial infarction, cardiac arrhythmias, cerebral vascular event or heart failure
* Smoking active patients in the last 6 months
* Patients with a desire for close conception, pregnant or breastfeeding.
* Patients with blood pressure \<90/60 mmHg
* Patients who do not accept to participate in the study
* Patients with a BMI greater than ≥40 Kg / m2
* Non-palpable carotid and femoral pulses
* Unstable psychological state
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Guadalajara

OTHER

Sponsor Role lead

Responsible Party

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Mónica VázquezdelMercadoEspinosa

PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Monica Vázquez-Del Mercado, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Guadalajara

Locations

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Instituto de Investigación en Reumatología y Sistema Músculo Esquelético

Guadalajara, Jalisco, Mexico

Site Status

Countries

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Mexico

References

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Gossec L, Dougados M, Dixon W. Patient-reported outcomes as end points in clinical trials in rheumatoid arthritis. RMD Open. 2015 Apr 2;1(1):e000019. doi: 10.1136/rmdopen-2014-000019. eCollection 2015.

Reference Type BACKGROUND
PMID: 26509052 (View on PubMed)

Burmester GR, Feist E, Dorner T. Emerging cell and cytokine targets in rheumatoid arthritis. Nat Rev Rheumatol. 2014 Feb;10(2):77-88. doi: 10.1038/nrrheum.2013.168. Epub 2013 Nov 12.

Reference Type BACKGROUND
PMID: 24217582 (View on PubMed)

Gibofsky A. Overview of epidemiology, pathophysiology, and diagnosis of rheumatoid arthritis. Am J Manag Care. 2012 Dec;18(13 Suppl):S295-302.

Reference Type BACKGROUND
PMID: 23327517 (View on PubMed)

Gkaliagkousi E, Gavriilaki E, Doumas M, Petidis K, Aslanidis S, Stella D. Cardiovascular risk in rheumatoid arthritis: pathogenesis, diagnosis, and management. J Clin Rheumatol. 2012 Dec;18(8):422-30. doi: 10.1097/RHU.0b013e31827846b1.

Reference Type BACKGROUND
PMID: 23188207 (View on PubMed)

Solomon DH, Karlson EW, Rimm EB, Cannuscio CC, Mandl LA, Manson JE, Stampfer MJ, Curhan GC. Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation. 2003 Mar 11;107(9):1303-7. doi: 10.1161/01.cir.0000054612.26458.b2.

Reference Type BACKGROUND
PMID: 12628952 (View on PubMed)

Kramer HR, Giles JT. Cardiovascular disease risk in rheumatoid arthritis: progress, debate, and opportunity. Arthritis Care Res (Hoboken). 2011 Apr;63(4):484-99. doi: 10.1002/acr.20386. No abstract available.

Reference Type BACKGROUND
PMID: 21452262 (View on PubMed)

Crowson CS, Nicola PJ, Kremers HM, O'Fallon WM, Therneau TM, Jacobsen SJ, Roger VL, Ballman KV, Gabriel SE. How much of the increased incidence of heart failure in rheumatoid arthritis is attributable to traditional cardiovascular risk factors and ischemic heart disease? Arthritis Rheum. 2005 Oct;52(10):3039-44. doi: 10.1002/art.21349.

Reference Type BACKGROUND
PMID: 16200583 (View on PubMed)

Kremers HM, Crowson CS, Therneau TM, Roger VL, Gabriel SE. High ten-year risk of cardiovascular disease in newly diagnosed rheumatoid arthritis patients: a population-based cohort study. Arthritis Rheum. 2008 Aug;58(8):2268-74. doi: 10.1002/art.23650.

Reference Type BACKGROUND
PMID: 18668561 (View on PubMed)

Crilly MA, Kumar V, Clark HJ, Scott NW, Macdonald AG, Williams DJ. Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis: a dose-response relationship independent of established cardiovascular risk factors. Rheumatology (Oxford). 2009 Dec;48(12):1606-12. doi: 10.1093/rheumatology/kep305. Epub 2009 Oct 25.

Reference Type BACKGROUND
PMID: 19858120 (View on PubMed)

Klocke R, Cockcroft JR, Taylor GJ, Hall IR, Blake DR. Arterial stiffness and central blood pressure, as determined by pulse wave analysis, in rheumatoid arthritis. Ann Rheum Dis. 2003 May;62(5):414-8. doi: 10.1136/ard.62.5.414.

Reference Type BACKGROUND
PMID: 12695151 (View on PubMed)

Park S, Lakatta EG. Role of inflammation in the pathogenesis of arterial stiffness. Yonsei Med J. 2012 Mar;53(2):258-61. doi: 10.3349/ymj.2012.53.2.258.

Reference Type BACKGROUND
PMID: 22318811 (View on PubMed)

Roman MJ, Devereux RB, Schwartz JE, Lockshin MD, Paget SA, Davis A, Crow MK, Sammaritano L, Levine DM, Shankar BA, Moeller E, Salmon JE. Arterial stiffness in chronic inflammatory diseases. Hypertension. 2005 Jul;46(1):194-9. doi: 10.1161/01.HYP.0000168055.89955.db. Epub 2005 May 23.

Reference Type BACKGROUND
PMID: 15911740 (View on PubMed)

Vazquez-Del Mercado M, Nunez-Atahualpa L, Figueroa-Sanchez M, Gomez-Banuelos E, Rocha-Munoz AD, Martin-Marquez BT, Corona-Sanchez EG, Martinez-Garcia EA, Macias-Reyes H, Gonzalez-Lopez L, Gamez-Nava JI, Navarro-Hernandez RE, Nunez-Atahualpa MA, Andrade-Garduno J. Serum levels of anticyclic citrullinated peptide antibodies, interleukin-6, tumor necrosis factor-alpha, and C-reactive protein are associated with increased carotid intima-media thickness: a cross-sectional analysis of a cohort of rheumatoid arthritis patients without cardiovascular risk factors. Biomed Res Int. 2015;2015:342649. doi: 10.1155/2015/342649. Epub 2015 Mar 2.

Reference Type BACKGROUND
PMID: 25821796 (View on PubMed)

Wallberg-Jonsson S, Caidahl K, Klintland N, Nyberg G, Rantapaa-Dahlqvist S. Increased arterial stiffness and indication of endothelial dysfunction in long-standing rheumatoid arthritis. Scand J Rheumatol. 2008 Jan-Feb;37(1):1-5. doi: 10.1080/03009740701633238.

Reference Type BACKGROUND
PMID: 18189187 (View on PubMed)

Vazquez-Del Mercado M, Gomez-Banuelos E, Chavarria-Avila E, Cardona-Munoz E, Ramos-Becerra C, Alanis-Sanchez A, Cardona-Muller D, Grover-Paez F, Perez-Vazquez FJ, Navarro-Hernandez RE, Valadez-Soto JM, Saldana-Millan AA, Gonzalez-Rosas L, Ramos-Lopez G, Petri MH, Back M. Disease duration of rheumatoid arthritis is a predictor of vascular stiffness: a cross-sectional study in patients without known cardiovascular comorbidities: A STROBE-compliant article. Medicine (Baltimore). 2017 Aug;96(33):e7862. doi: 10.1097/MD.0000000000007862.

Reference Type BACKGROUND
PMID: 28816989 (View on PubMed)

Perez-Vazquez F, Back M, Chavarria-Avila E, Gomez-Banuelos E, Ramos-Becerra CG, Pizano-Martinez O, Salazar-Paramo M, Grover-Paez F, Nava-Zavala AH, Cardona-Munoz EG, Cardona-Muller D, Duran-Barragan S, Mera-Riofrio VN, Prado-Bachega N, Vazquez-Del Mercado M. Enalapril Influence on Arterial Stiffness in Rheumatoid Arthritis Women: A Randomized Clinical Trial. Front Med (Lausanne). 2020 Jan 29;6:341. doi: 10.3389/fmed.2019.00341. eCollection 2019.

Reference Type DERIVED
PMID: 32118001 (View on PubMed)

Other Identifiers

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EEVA

Identifier Type: -

Identifier Source: org_study_id

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