Treatment Optimisation for Blood Pressure With Single-Pill Combinations in India

NCT ID: NCT05683301

Last Updated: 2024-10-08

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

PHASE4

Total Enrollment

1981 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-30

Study Completion Date

2024-09-22

Brief Summary

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Hypertension is a leading cause of morbidity and mortality globally. Although multiple drugs are frequently used to treat it, in the South Asian context, evidence is lacking on best drug combinations. This trial aims to compare efficacy of three single-pill combinations of two anti-hypertensive agents on 24-hour ambulatory systolic blood pressure among 1968 individuals with hypertension. The trial is a single-blind randomized controlled trial spread across 37 hospitals in India.

Single Pill combinations (SPCs): 1) Amlodipine + Perindopril, 2) Perindopril + Indapamide, 3) Amlodipine + Indapamide

Detailed Description

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This is a multi-centre, individual randomized single-blind, parallel group, three-armed superiority trial to compare the efficacy of three different single-pill combinations of antihypertensive therapies (Amlodipine/Perindopril, Perindopril/Indapamide, and Amlodipine/Indapamide)on 24-hour ambulatory BP levels in Indians.

Conditions

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Primary Hypertension

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Arm 1

(Arm 1 compare to Arm 2 compare to Arm 3) - Treatment Period 1 (Enrollment - 2 months) - Single Pill Combination of Amlodipine 5 mg and Perindopril 4 mg once daily, orally Treatment Period 2 (2 months - 6 months) - Single Pill Combination of Amlodipine 10 mg and Perindopril 8 mg once daily, orally

Group Type EXPERIMENTAL

Amlodipine + Perindopril

Intervention Type DRUG

Single pill combination of dual antihypertensive agent

Arm 2

(Arm 1 compare to Arm 2 compare to Arm 3) - Treatment Period 1 (Enrollment - 2 months) - Single Pill Combination of Perindopril 4 mg and Indapamide 1.25 mg once daily, orally Treatment Period 2 (2 months - 6 months) - Single Pill Combination of Perindopril 8 mg and Indapamide 2.5 mg once daily, orally

Group Type EXPERIMENTAL

Perindopril + Indapamide

Intervention Type DRUG

Single pill combination of dual antihypertensive agent

Arm 3

(Arm 1 compare to Arm 2 compare to Arm 3) - Treatment Period 1 (Enrollment - 2 months) - Single Pill Combination of Amlodipine 5 mg and Indapamide 1.5 mg sustained release once daily, orally Treatment Period 2 (2 months - 6 months) - Single Pill Combination of Amlodipine 10 mg and Indapamide 1.5 mg sustained release once daily, orally

Group Type EXPERIMENTAL

Amlodipine + Indapamide

Intervention Type DRUG

Single pill combination of dual antihypertensive agent

Interventions

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Amlodipine + Perindopril

Single pill combination of dual antihypertensive agent

Intervention Type DRUG

Perindopril + Indapamide

Single pill combination of dual antihypertensive agent

Intervention Type DRUG

Amlodipine + Indapamide

Single pill combination of dual antihypertensive agent

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Age 30-79 years AND
2. Sitting clinic values\* of SBP ≥140 mmHg and \<160 mmHg on one antihypertensive agent OR
3. Sitting clinic values\* of SBP ≥150 mmHg and \<180 mmHg on no antihypertensive treatment \* Mean of the last 2 of 3 readings.

Exclusion Criteria

1. Congestive heart failure (clinically defined).
2. Patients with a history of intolerance to any of the study medications for example angioedema or dry cough with Angiotensin-converting enzyme inhibitors.
3. Serum creatinine levels greater than 132.6µmol/l (1.5mg/dl)
4. 4\. History of coronary heart disease (i.e., chronic stable angina, myocardial infarction or acute coronary syndrome).
5. History of a stroke or other cerebrovascular accident (i.e. transient ischaemic attack or reversible ischaemic neurological deficit).
6. Severe hepatic impairment
7. Treatment with agents causing torsades de pointes
8. Lactation
9. Contraindications to any of the investigational medicinal products as per the summaries product characteristics of drugs studied
10. Known or suspected secondary hypertension.
11. Any other concomitant illness, physical or mental impairment that could interfere with the effective conduct of the study.
12. Pregnancy or those of child-bearing age who are not taking reliable contraception.
13. History of Gout.
14. Serum potassium \< 3.5mmol/L at screening.

\-
Minimum Eligible Age

30 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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All India Institute of Medical Sciences

OTHER

Sponsor Role collaborator

Imperial College London

OTHER

Sponsor Role collaborator

Centre for Chronic Disease Control, India

OTHER

Sponsor Role lead

Responsible Party

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Dr. Dorairaj Prabhakaran

Executive Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dorairaj Prabhakaran, DM Cardiology

Role: PRINCIPAL_INVESTIGATOR

Centre for Chronic Disease Control, New Delhi

Locations

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Lalitha Super Specialities Hospital

Guntur, Andhra Pradesh, India

Site Status

Apollo Hospitals

Visakhapatnam, Andhra Pradesh, India

Site Status

Assam Medical College

Dibrugarh, Assam, India

Site Status

Apollo-Excelcare Hospital

Guwahati, Assam, India

Site Status

Rudraksha Hospital

Ahmedabad, Gujarat, India

Site Status

Apollo Hospitals

Ahmedabad, Gujarat, India

Site Status

Aman Hospital & Research Center

Vadodara, Gujarat, India

Site Status

Lifecare Hospital & Research Centre

Bangalore, Karnataka, India

Site Status

SDM College of Medical Sciences & Hospital

Dharwad, Karnataka, India

Site Status

Indiana Hospital & Heart Institute

Mangalore, Karnataka, India

Site Status

JSS Hospital

Mysore, Karnataka, India

Site Status

BLDE, Shri B. M. Patil Medical College, Hospital & Research Centre

Vijayapura, Karnataka, India

Site Status

Lisie Hospital

Ernākulam, Kerala, India

Site Status

Lakshmi Hospital

Palakkad, Kerala, India

Site Status

BKL Walawalkar Rural Medical College and Hospital

Devran, Maharashtra, India

Site Status

Bhatia Hospital

Mumbai, Maharashtra, India

Site Status

Sengupta Hospital & Research Institute

Nagpur, Maharashtra, India

Site Status

Shalinitai Meghe Hospital and Research Center

Nagpur, Maharashtra, India

Site Status

Nazareth Hospital

Shillong, Meghālaya, India

Site Status

North Eastern Indira Gandhi Regional Institute of Medical Sciences

Shillong, Meghālaya, India

Site Status

All India Institute of Medical Sciences

New Delhi, National Capital Territory of Delhi, India

Site Status

Indraprastha Apollo Hospitals

New Delhi, National Capital Territory of Delhi, India

Site Status

Apollo Hospitals

Bhubaneshwar, Odisha, India

Site Status

All India Institute of Medical Sciences

Bathinda, Punjab, India

Site Status

Dayanand Medical College and Hospital

Ludhiana, Punjab, India

Site Status

Sadbhavna Medical and Heart Institute

Patiāla, Punjab, India

Site Status

SP Medical College

Bikaner, Rajasthan, India

Site Status

All India Institute of Medical Sciences

Jodhpur, Rajasthan, India

Site Status

Madras Medical College

Chennai, Tamil Nadu, India

Site Status

Sri Ramchandra Institute of Higher Education and Research

Chennai, Tamil Nadu, India

Site Status

Apollo Hospital

Madurai, Tamil Nadu, India

Site Status

Osmania General Hospital

Hyderabad, Telangana, India

Site Status

Apollo DRDO Hospitals

Hyderabad, Telangana, India

Site Status

Apollo Institute of Medical Sciences

Hyderabad, Telangana, India

Site Status

Mediciti Institute of Medical Sciences

Hyderabad, Telangana, India

Site Status

Countries

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India

References

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Prabhakaran D, Roy A, Chandrasekaran AM, Kondal D, Mukherjee S, Kiru G, Singh K, Salwa H, Sobitharaj EC, Lobo AS, Mahajan G, Mohan B, Khanna A, Malviya A, Patil SG, Abichandani VK, Singh B, Gupta BK, Yellapantula B, Dandge S, Sengupta S, Kumar S, Bardoloi N, Senguttuvan NB, Sahay RK, Patil S, Deora S, Prahalad R, Sarvepalli VP, Gnanaraj JP, Khanna M, Mishra A, Aithal K, Chavda V, Cornelius VR; TOPSPIN Clinical Consortia; Poulter NR. Comparison of dual therapies for hypertension treatment in India: a randomized clinical trial. Nat Med. 2025 Sep;31(9):3169-3175. doi: 10.1038/s41591-025-03854-w. Epub 2025 Jul 25.

Reference Type DERIVED
PMID: 40715816 (View on PubMed)

Other Identifiers

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CCDC-2022-001

Identifier Type: -

Identifier Source: org_study_id

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