Open-label inteRventional Clinical Trial to Assess Efficacy and Safety of the exteMporaneous combInation of Nebivolol and Ramipril in hypertenSIve pAtients

Launched by MENARINI INTERNATIONAL OPERATIONS LUXEMBOURG SA · Oct 23, 2023

Keywords

ClinConnect Summary

This clinical trial is testing a new way to treat high blood pressure (hypertension) using a combination of two medications: Nebivolol and Ramipril. The goal is to see if this combination is effective and safe for patients who currently take one of these medications on their own. The study is open to men and women aged 18 to 65 who have high blood pressure and are already on a treatment plan with either Nebivolol or Ramipril for at least 30 days. Participants must be able to take oral medications and agree to follow the study's guidelines.

If you qualify and choose to participate, you will be monitored closely throughout the study to ensure your safety and to measure how well the new treatment works. It's important to note that women who can become pregnant will need to use effective birth control during the study, and both men and women must agree to avoid donating sperm or eggs. This trial is actively recruiting participants, so if you or someone you know has high blood pressure and meets the criteria, this could be an opportunity to contribute to important research in hypertension treatment.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• Patient will be considered eligible to be enrolled in the study only if he/she meets all the following inclusion criteria:
• • 1. Willing to comply with all study activities and procedures for the duration of the study and provided signed, written informed consent prior to any study procedures at Screening Visit.
• • 2. Male or female patients aged ≥ 18 years with hypertension with mean sitting SBP ≥ 140 mmHg and ≤ 179 mmHg and/or mean sitting DBP ≥ 90 mmHg and
• • ≤ 109 mmHg at Visit 1 (screening), while on monotherapy treatment either with BBs (NEB 5 mg or any dose if other BB) or ACE-is (RAM 5 mg or any dose if other ACE-i) for at least 30 days before Visit 1 (screening) and, as per Investigator's judgement, is deemed appropriate for a combination treatment with BB and ACE-i.
• • 3. Ability to take oral medication and willing to adhere to the drug regimen.
• 4. Female patient of childbearing potential is eligible to participate if she is not pregnant, or not breastfeeding. A woman is considered fertile following menarche and until becoming postmenopausal unless permanently sterile. Women of childbearing potential must agree to use of highly effective contraception (e.g., method of birth control throughout the study period and for 4 weeks after study completion defined as a method which results in a failure rate of less than 1% per year) and also must refrain from donating or storing eggs during this time. Highly effective contraception methods can be:
• • Combined hormonal contraception (estrogen- and progestogen-containing) associated with inhibition of ovulation (oral, intravaginal, and transdermal).
• • Progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, and implantable).
• • Intrauterine device.
• • Intrauterine hormone-releasing system.
• • Bilateral tubal occlusion.
• • Vasectomized partner (procedure conducted at least 2 months before the screening), (provided that partner is the sole sexual partner of the trial participant and that the vasectomized partner has received medical assessment of the surgical success).
• • 5. A male patient must agree to use contraception during the whole study period and for at least 1 week after the last dose of study treatment and refrain from donating sperm during this period.
• Exclusion Criteria:
• Any patient who meets any of the following criteria will not qualify for entry into the study:
• • 1. Patients with documented history of hypersensitivity to NEB, RAM, other BBs or other ACE-is, or any related products, excipients of the formulations, as outlined in the relevant Investigator's Brochure (IB), summary of product characteristics (SmPC) or local package inserts for Nebivolol and Ramipril.
• • 2. Patients with serious disorders (in the opinion of the Investigator) which may limit the ability to evaluate the efficacy or safety of the tested medications, including cerebrovascular, cardiovascular, renal, respiratory, hepatic, gastrointestinal, endocrine, or metabolic, hematological, or oncological, neurological, and psychiatric diseases. The same applies for immunocompromised and/or neutropenic patients.
• 3. Patients having a history of the following conditions within the last 6 months:
• • myocardial infarction, unstable angina pectoris, percutaneous coronary intervention, bypass surgery, heart failure, hypertensive encephalopathy, valve replacement (transcatheter aortic valve implantation, mitraclip), cerebrovascular accident (stroke), or transient ischemic attack.
• • 4. Patients with condition of hypotension with SBP \< 90 mmHg and/or DBP \< 60 mmHg.
• • 5. Acute heart failure (12 months before enrolment), cardiogenic shock, or episodes of heart failure decompensation requiring intravenous inotropic therapy.
• • 6. Patients with secondary hypertension of any etiology including renal diseases, Cushing's syndrome, hyperaldosteronism, renovascular disease and thyroid disorders.
• • 7. Patients with severe heart failure (New York Heart Association classification III-IV) a narrowing of the aortic or bicuspid valve, an obstruction of cardiac outflow (obstructive, hypertrophic cardiomyopathy), obstruction of the outflow tract of the left ventricle (e.g., high grade aortic stenosis) or symptomatic coronary disease.
• • 8. Patients with clinical evidence of renal disease (including significant bilateral renal artery stenosis or renal artery stenosis in a single functioning kidney), severe renal impairment or renal transplant.
• • 9. Patients with clinically relevant hepatic impairment.
• • 10. Patients with a history of angioneurotic edema.
• • 11. Patients with sick sinus syndrome, including sino-atrial block.
• • 12. Patient with second- and third-degree heart block (without a pacemaker).
• • 13. History of bronchospasm and bronchial asthma.
• • 14. Untreated phaeochromocytoma.
• • 15. Patients with bradycardia (heart rate \< 60 bpm; \< 50 bpm in patients already on BBs treatment).
• • 16. Patient with history of metabolic acidosis.
• • 17. Patients with severe peripheral circulatory disturbances.
• • 18. Participation in another interventional study within the last 30 days before Screening Visit (Visit 1).
• • 19. Patients with diseases that, in the opinion of the Investigator, prevent a careful adherence to the protocol.
• • 20. Patients using and not suitable for withdrawing the prohibited medications prior to the administration of study treatment.
• • 21. Pregnant and breastfeeding women. NOTE: a pregnancy test will be performed on all women of childbearing potential at each study visit.
• • 22. Patients with medical history of cirrhosis (Child Pugh class B or higher).
• • 23. History of unexplained syncope within the prior 2 years, or a known syncopal disorder.
• • 24. Patients who received renal denervation in the last 3 years or other device-based nonpharmacological treatment of hypertension.
• • 25. Any other contraindication to either NEB or RAM as per respective SmPC.