Moderato System in Patients With Hypertension

NCT ID: NCT03757377

Last Updated: 2022-12-14

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

203 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-08-30

Study Completion Date

2023-03-30

Brief Summary

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The purpose of this double blind randomized study is the evaluation of the safety and efficacy of the Moderato System. The Moderato implantable pulse generator is indicated for patients who have hypertension and also require a dual chamber pacemaker in order to reduce their blood pressure.

In this amended CS-03 protocol Version 3.0, the study will evaluate the safety and efficacy in a randomized, double-blind study following active treatment vs. a control patient population for a period of 3 month for efficacy and 12 months for safety (In comparison to 6 months for patients under protocol CS-03 Ver 1.1, NCT02837445).

The device will be considered to have a clinical effectiveness with regard to its anti-hypertension function if there is a statistically significant and clinically meaningful reduction in mean 24-hour ambulatory systolic blood pressure in the treatment group compared to the control group. The primary efficacy endpoint will be evaluated 3 months after randomization. The Primary safety analysis will compare the treatment and the control after 12 months of treatment.

Detailed Description

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Protocol CS-03 Ver 1.1 (NCT02837445) was amended at the advice of the Scientific Advisory to protocol CS-03 Version 3.0 with more stringent hypertension inclusion criteria and different observation intervals for efficacy and safety.

In CS-03 Version 3.0 the time of the primary efficacy endpoint was reduced from 6 months to 3 months post randomization which was deemed a suitable interval for the chronic effect, whereas for the safety endpoint, the period was lengthened to 12 months post randomization to better monitor potential risks of the treatment on cardiac function (Blinding period was increased from 6 months to 12 months). Protocols were thus split in order to allow better clarification to the difference in the time to the primary endpoints for efficacy and safety between the two CIP versions and simplify data analysis.

Protocol Ver 3.0 prescribes data analysis of all patients randomized under version 1.1 to be performed once they complete the 6 months follow-up as set in protocol version 1.1 (NCT0283744). It is expected that \~40 patients will be randomized according to protocol version 1.1 prior to the enrollment of patients according to protocol version 3.0. The results will be considered as interim analysis.

The recruitment for the protocol version 1.1 is now completed. Total of 47 patients were randomized according to protocol version 1.1 and all patients completed the follow-up period for the primary endpoint.

Patients are currently being followed up for the study "extension period".

Conditions

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Hypertension, Resistant to Conventional Therapy Atrioventricular Block

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Double (Participant, Investigator)

Study Groups

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BackBeat Moderato System (PHC ON)

Eligible patients randomized after optimization phase to PHC ON (PHC algorithm active) for 12 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator.

Group Type ACTIVE_COMPARATOR

BackBeat Moderato System

Intervention Type DEVICE

Eligible patients randomized after optimization phase to PHC ON for 12 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator

BackBeat Moderato System (PHC OFF)

Eligible patients randomized after optimization phase to pacemaker only (PHC OFF or PHC algorithm not active) for 12 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator.

Group Type PLACEBO_COMPARATOR

BackBeat Moderato Sytsem

Intervention Type DEVICE

Eligible patients randomized after optimization phase to PHC OFF for 12 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator.

Interventions

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BackBeat Moderato System

Eligible patients randomized after optimization phase to PHC ON for 12 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator

Intervention Type DEVICE

BackBeat Moderato Sytsem

Eligible patients randomized after optimization phase to PHC OFF for 12 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Requirement of dual chamber pacemaker or upgrade from a single chamber to a dual chamber pacemaker.
* Stable (at least 6 weeks) hypertension treatment with at least 1 anti-hypertensive drug, which is anticipated to be maintained without changes. Stable is defined as being in the same drug regimen, and the dose of each drug(s) no more than 50% reduced or 100% increased over the past 6 weeks.
* Average 24-hour ambulatory systolic blood pressure ≥ 130 mmHg (with directly observed medical therapy, DOT) and office blood pressure ≥140 mmHg.
* Subject is able to comply with study visits for at least 13 months (e.g., is capable and willing to travel to/from the center for all scheduled study visits).

Exclusion Criteria

* Known secondary cause of HTN.
* Average ambulatory or office systolic BP \> 195 mmHg.
* Permanent atrial fibrillation.
* History of significant paroxysmal atrial fibrillation/flutter burden (defined as \>25% of beats).
* Cardiac ejection fraction \<50%.
* Symptoms of heart failure, NYHA Class II or greater.
* Hypertrophic cardiomyopathy, restrictive cardiomyopathy or inter-ventricular septal thickness ≥ 15 mm.
* Subject is on dialysis.
* Subject has an estimated Glomerular Filtration Rate \< 30 ml/min/1.73 m²
* Prior neurological events (stroke or TIA) within the past year or events at a prior time that has resulted in residual neurologic deficit.
* Carotid artery disease.
* Known autonomic dysfunction.
* History of clinically significant untreated ventricular tachyarrhythmia or has experienced cardiac arrest.
* Previous active device-based treatment for HTN.
* Existing implant, other than a pacemaker that needs replacing.
* Subject is or has the possibility of becoming pregnant and is unwilling of contraception during the study.
* Subject is unwilling or cannot provide Informed Consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Massachusetts General Hospital

OTHER

Sponsor Role collaborator

MLM Medical Labs GmbH

INDUSTRY

Sponsor Role collaborator

nabios GmbH

UNKNOWN

Sponsor Role collaborator

BackBeat Medical Inc

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Karl-Heinz Kuck, Prof. MD

Role: PRINCIPAL_INVESTIGATOR

Asklepios Klinik St. Georg

Locations

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UZ Brussel - Heart Rhythm Management Center

Brussels, , Belgium

Site Status

Vilnius University Hospital Santariskiu Klinikos

Vilnius, , Lithuania

Site Status

Samodzielnym Publicznym Centralnym Szpitalem Klinicznym

Warsaw, , Poland

Site Status

Silesian Center for Heart Diseases

Zabrze, , Poland

Site Status

Countries

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United Kingdom Belgium Lithuania Poland

Related Links

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https://www.ncbi.nlm.nih.gov/pubmed/?term=29628351

Rationale and evidence for the development of a durable device-based cardiac neuromodulation therapy for hypertension.

https://www.ncbi.nlm.nih.gov/pubmed/?term=29275370

Pacemaker-Mediated Programmable Hypertension Control Therapy.

Other Identifiers

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CS-03 Ver 3.0

Identifier Type: -

Identifier Source: org_study_id