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TElmisartan and AMlodipine Single Pill sTudy With Patients Not on Goal With Mono rAas Therapy-switch

A Prospective, Open-label TElmisartan/AMlodipine Single Pill STudy to Assess the Efficacy in Patients With Essential Hypertension...

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01134393
Enrollment
502
Registered
2010-06-02
Start date
2010-05-31
Completion date
Unknown
Last updated
2014-01-15

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hypertension

Brief summary

The general aim of this trial to determine the efficacy as measured by the percentage of patients reaching blood pressure goal at the end of the treatment period at 12 weeks. In-clinic blood pressures, home blood pressures and safety will be carefully monitored.

Detailed description

Study Design:

Interventions

start low dose and uptitrate to high dose on the basis of BP goal

Sponsors

Boehringer Ingelheim
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No

Inclusion criteria

1. Ability to provide written informed consent in accordance with Good Clinical Practice and local legislation 2. Age 18 years or older 3. Patients with uncontrolled hypertension as defined SBP \> 140 mmHg and SBP \> 130 mmHg in patients with diabetes or renal impairment or DBP \> 90 mmHg and DBP \>80 mmHg in patients with diabetes or renal impairment after at least an 6 weeks of stable treatment with antihypertensive medication defined as treatment with the clinically recommended dose of a single RAAS blocking agent (Angiotensin Converting Enzym inhibition, AII Receptor Blocker and Direct Renin Inhibitor) at entering the trial. Renal impairment is defined as a creatinine \>133µmol/l (1.5mg/dl) in male patients and a creatinine \>124µmol/l (1.3mg/dl) in female patients or a creatinine clearance between 30-60 ml/min

Exclusion criteria

1. Pre-menopausal women who are not surgically sterile; or are nursing or pregnant; or are not practising acceptable means of birth control or do not plan to continue using acceptable means of birth control throughout the study and do not agree to submit to pregnancy testing during participation in the trial. Acceptable methods of birth control include the transdermal patch, oral, implantable or injectable contraceptives, sexual abstinence and vasectomised partner. 2. Known or suspected secondary hypertension (e.g., renal artery stenosis or phaeochromocytoma). 3. Mean in-clinic seated cuff Systolic BP \>180 mmHg and SBP \>160 mmHg in patients with diabetes or renal impairment or Diastolic BP \>110 mmHg and DBP \>100 mmHg in patients with diabetes or renal impairment. Renal impairment is defined as a creatinine \>133µmol/l (1.5mg/dl) in male patients and a creatinine \>124µmol/l (1.3mg/dl) in female patients or a creatinine clearance between 30-60 ml/min. 4. Renal dysfunction as defined by the following laboratory parameters: Serum creatinine \>3.0 mg/dl (or \>265 ¿mol/L) and/or known creatinine clearance of \<30 ml/min and/or clinical markers of severe renal impairment. 5. Bilateral renal artery stenosis, renal artery stenosis in a solitary kidney, post-renal transplant patients or patients with only one kidney. 6. Clinically relevant hypokalaemia or hyperkalaemia (i.e., \<3.5 or \>5.5 mEq/L). 7. Uncorrected sodium or volume depletion. 8. Primary aldosteronism. 9. Hereditary fructose intolerance. 10. Congestive heart failure New York Heart Association functional class Congestive Heart Failure III-IV (Refer to Appendix 10.1). 11. Clinically significant ventricular tachycardia, atrial fibrillation, atrial flutter or other clinically relevant cardiac arrhythmias as determined by the Investigator. 12. Biliary obstructive disorders (e.g., cholestasis) or hepatic insufficiency (defined as elevated levels of \>2x bilirubin or \>2x transaminases values). (Refer to Appendix 10.3) 13. Patients who have previously experienced symptoms characteristic of angioedema during treatment with ACE inhibitors or angiotensin-II receptor antagonists. 14. History of drug or alcohol dependency within six months prior to signing the informed consent form. 15. Any investigational drug therapy within one month of signing the informed consent. 16. Known hypersensitivity to any component of the trial drugs (telmisartan or amlodipine). 17. History of non-compliance or inability to comply with prescribed medications or protocol procedures. 18. Any other clinical condition which, in the opinion of the investigator, would not allow safe completion of the protocol and safe administration of the trial medication.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Patients Achieving Blood Pressure (BP) Control After 12 Weeks of Treatment Using In-clinic BP Measurements.12 weeksAchieving BP control is defined as SBP\<140 mmHg and DBP\<90 mmHg.

Secondary

MeasureTime frameDescription
BP Control (Morning and Evening) After 12 Weeks of Treatment Using Home Blood Pressure Measurement (HBPM).Week 12Achieving BP control with HBPM is defined as SBP\<135 mmHg and DBP\<85 mmHg.
Change From Baseline Over Time in In-clinic Measured Mean SBP and Mean DBPweeks 4, 8 and 12
Change From Baseline Over Time in In-clinic Measured Mean Pulse Rateweeks 4, 8 and 12Pulse pressure was not analysed for this study instead pulse rate was analysed at weeks 4, 8 and 12.
Change From Baseline Over Time in In-clinic Measured Mean Pulse Pressureweeks 4, 8 and 12
BP Control After 4 and 8 Weeks of Treatment Using In-clinic BP Measurements.4 and 8 weeksAchieving BP control is defined as SBP\<140 mmHg and DBP\<90 mmHg.
Percentage of Patients in Blood Pressure Categories Over Timeweeks 4, 8 and 12BP optimal: SBP \<120 mmHg and DBP \<80 mmHg, BP normal: SBP \<130 mmHg and DBP \<85 mmHg but not optimal, BP high-normal: SBP \<140 mmHg and DBP \<90 mmHg but not normal. Grade 1 hypertension: SBP \<160 mmHg and DBP \<100 mmHg but not high-normal, Grade 2 hypertension: SBP \<180 mmHg and DBP \<110 mmHg but not grade 1, Grade 3 hypertension: SBP \>=180 mmHg or DBP \>=110 mmHg.
DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM Measurementsweeks 4, 8 and 12DBP control: DBP \<85 mmHg, SBP control: SBP \<135 mmHg, DBP response: DBP \<85 mmHg or a reduction from baseline \>=10 mmHg, SBP response: SBP \<135 mmHg or a reduction from baseline \>= 15 mmHg
Frequency of Patients Requiring Up-titration to Telmisartan 80mg Plus Amlodipine 10mg Combination (T80/A10) to Achieve Blood Pressure Control Over Timeweeks 4 and 8
DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP Measurementsweeks 4, 8 and 12DBP control is defined as DBP \<90 mmHg or \<80 mmHg in patients with diabetes or renal impairment. SBP control is defined as SBP \<140 mmHg or \<130 mmHg in patients with diabetes or renal impairment. DBP response is defined as DBP \<90 mmHg or \<80 mmHg in patients with diabetes or renal impairment or a reduction from baseline \>=10mmHg. SBP response is defined as SBP\<140 mmHg or \<130 mmHg in patients with diabetes or renal impairment or a reduction from baseline \>=15mmHg.

Countries

Germany, Italy, Mexico, Netherlands, Poland

Participant flow

Pre-assignment details

This was a prospective, single-arm, open-label, uncontrolled, multi-centre, international trial. Whilst 542 patients were enrolled, 502 entered the study. Since one patient refused to take study medication, only 501 patients were treated. The Full analysis set (FAS) consisted of 494 patients and this is the basis of most data presentations.

Participants by arm

ArmCount
T80/A5
Telmisartan 80mg plus Amlodipine 5mg fixed-dose combination
494
Total494

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event18
Overall StudyLack of Efficacy2
Overall StudyLost to Follow-up3
Overall StudyOther6
Overall StudyProtocol Violation12
Overall StudyWithdrawal by Subject11

Baseline characteristics

CharacteristicT80/A5
Age, Continuous58.0 Years
STANDARD_DEVIATION 11.5
Diastolic Blood Pressure (DBP) at time of baseline91.8 mmHg
STANDARD_DEVIATION 8.8
Sex: Female, Male
Female
207 Participants
Sex: Female, Male
Male
287 Participants
Systolic Blood Pressure (SBP) at time of baseline151.4 mmHg
STANDARD_DEVIATION 10.2

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
26 / 50141 / 232
serious
Total, serious adverse events
1 / 5011 / 232

Outcome results

Primary

Percentage of Patients Achieving Blood Pressure (BP) Control After 12 Weeks of Treatment Using In-clinic BP Measurements.

Achieving BP control is defined as SBP\<140 mmHg and DBP\<90 mmHg.

Time frame: 12 weeks

Population: Full Analysis Set (FAS) is defined as all patients who took at least one dose of trial medication, and for whom a baseline measurement and at least one post-baseline efficacy measurement were available. Last observation carried forward (LOCF) will be used.

ArmMeasureValue (NUMBER)
T80/A5Percentage of Patients Achieving Blood Pressure (BP) Control After 12 Weeks of Treatment Using In-clinic BP Measurements.67.6 Percentage of participants
Secondary

BP Control After 4 and 8 Weeks of Treatment Using In-clinic BP Measurements.

Achieving BP control is defined as SBP\<140 mmHg and DBP\<90 mmHg.

Time frame: 4 and 8 weeks

Population: FAS and LOCF

ArmMeasureGroupValue (NUMBER)
T80/A5BP Control After 4 and 8 Weeks of Treatment Using In-clinic BP Measurements.Week 4262 Number of participants
T80/A5BP Control After 4 and 8 Weeks of Treatment Using In-clinic BP Measurements.Week 8330 Number of participants
Secondary

BP Control (Morning and Evening) After 12 Weeks of Treatment Using Home Blood Pressure Measurement (HBPM).

Achieving BP control with HBPM is defined as SBP\<135 mmHg and DBP\<85 mmHg.

Time frame: Week 12

Population: FAS and LOCF and with at least one post baseline HBPM measurement

ArmMeasureGroupValue (NUMBER)
T80/A5BP Control (Morning and Evening) After 12 Weeks of Treatment Using Home Blood Pressure Measurement (HBPM).Morning179 Number of participants
T80/A5BP Control (Morning and Evening) After 12 Weeks of Treatment Using Home Blood Pressure Measurement (HBPM).Evening172 Number of participants
Secondary

Change From Baseline Over Time in In-clinic Measured Mean Pulse Pressure

Time frame: weeks 4, 8 and 12

Population: There was no information in the Case Report Form (CRF)

Secondary

Change From Baseline Over Time in In-clinic Measured Mean Pulse Rate

Pulse pressure was not analysed for this study instead pulse rate was analysed at weeks 4, 8 and 12.

Time frame: weeks 4, 8 and 12

Population: Treated Set (TS) with non-missing data

ArmMeasureGroupValue (MEAN)Dispersion
T80/A5Change From Baseline Over Time in In-clinic Measured Mean Pulse RateChange at week 4 (N=482)1.43 bpmStandard Deviation 9.22
T80/A5Change From Baseline Over Time in In-clinic Measured Mean Pulse RateChange at week 8 (N=463)0.32 bpmStandard Deviation 9.21
T80/A5Change From Baseline Over Time in In-clinic Measured Mean Pulse RateChange at week 12 (N=344)0.51 bpmStandard Deviation 9.25
Secondary

Change From Baseline Over Time in In-clinic Measured Mean SBP and Mean DBP

Time frame: weeks 4, 8 and 12

Population: FAS with non-missing data

ArmMeasureGroupValue (MEAN)Dispersion
T80/A5Change From Baseline Over Time in In-clinic Measured Mean SBP and Mean DBPChange at week 4 SBP (N=485)-13.58 mmHgStandard Deviation 11.95
T80/A5Change From Baseline Over Time in In-clinic Measured Mean SBP and Mean DBPChange at week 8 SBP (N=487)-16.37 mmHgStandard Deviation 12.34
T80/A5Change From Baseline Over Time in In-clinic Measured Mean SBP and Mean DBPChange at week 12 SBP (N=487)-16.92 mmHgStandard Deviation 12.24
T80/A5Change From Baseline Over Time in In-clinic Measured Mean SBP and Mean DBPChange at week 4 DBP (N=485)-8.24 mmHgStandard Deviation 8.77
T80/A5Change From Baseline Over Time in In-clinic Measured Mean SBP and Mean DBPChange at week 8 DBP (N=487)-10.33 mmHgStandard Deviation 8.88
T80/A5Change From Baseline Over Time in In-clinic Measured Mean SBP and Mean DBPChange at week 12 DBP (N=487)-10.43 mmHgStandard Deviation 8.83
Secondary

DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP Measurements

DBP control is defined as DBP \<90 mmHg or \<80 mmHg in patients with diabetes or renal impairment. SBP control is defined as SBP \<140 mmHg or \<130 mmHg in patients with diabetes or renal impairment. DBP response is defined as DBP \<90 mmHg or \<80 mmHg in patients with diabetes or renal impairment or a reduction from baseline \>=10mmHg. SBP response is defined as SBP\<140 mmHg or \<130 mmHg in patients with diabetes or renal impairment or a reduction from baseline \>=15mmHg.

Time frame: weeks 4, 8 and 12

Population: FAS and LOCF

ArmMeasureGroupValue (NUMBER)
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 4 DBP control313 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 8 DBP control368 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 12 DBP control373 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 4 SBP control247 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 8 SBP control305 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 12 SBP control311 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 4 DBP response329 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 8 DBP response393 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 12 DBP response399 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 4 SBP response337 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 8 SBP response388 Number of participants
T80/A5DBP and SBP Control and Response Rates After 4, 8 and 12 Weeks of Treatment Using In-clinic BP MeasurementsWeek 12 SBP response393 Number of participants
Secondary

DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM Measurements

DBP control: DBP \<85 mmHg, SBP control: SBP \<135 mmHg, DBP response: DBP \<85 mmHg or a reduction from baseline \>=10 mmHg, SBP response: SBP \<135 mmHg or a reduction from baseline \>= 15 mmHg

Time frame: weeks 4, 8 and 12

Population: FAS and LOCF and with at least one post baseline HBPM measurement

ArmMeasureGroupValue (NUMBER)
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP control morning at week 8242 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP control morning at week 4256 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP control morning at week 12252 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP control evening at week 4272 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP control evening at week 8247 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP control evening at week 12263 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP control morning at week 4204 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP control morning at week 8198 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP control morning at week 12206 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP control evening at week 4204 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP control evening at week 8183 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP control evening at week 12190 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP response morning at week 4 (N=354)256 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP response morning at week 8 (N=354)242 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP response morning at week 12 (N=354)252 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP response evening at week 4 (N=354)272 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP response evening at week 8 (N=354)247 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsDBP response evening at week 12 (N=354)263 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP response morning at week 4 (N=299)204 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP response morning at week 8 (N=299)198 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP response morning at week 12 (N=299)206 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP response evening at week 4 (N=299)204 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP response evening at week 8 (N=299)183 Number of participants
T80/A5DBP and SBP Control and Response Rates Morning and Evening Over Time HBPM MeasurementsSBP response evening at week 12 (N=299)190 Number of participants
Secondary

Frequency of Patients Requiring Up-titration to Telmisartan 80mg Plus Amlodipine 10mg Combination (T80/A10) to Achieve Blood Pressure Control Over Time

Time frame: weeks 4 and 8

Population: FAS

ArmMeasureGroupValue (NUMBER)
T80/A5Frequency of Patients Requiring Up-titration to Telmisartan 80mg Plus Amlodipine 10mg Combination (T80/A10) to Achieve Blood Pressure Control Over TimeWeek 4 (n=482)186 Number of participants
T80/A5Frequency of Patients Requiring Up-titration to Telmisartan 80mg Plus Amlodipine 10mg Combination (T80/A10) to Achieve Blood Pressure Control Over TimeWeek 8 (n=284)46 Number of participants
Secondary

Percentage of Patients in Blood Pressure Categories Over Time

BP optimal: SBP \<120 mmHg and DBP \<80 mmHg, BP normal: SBP \<130 mmHg and DBP \<85 mmHg but not optimal, BP high-normal: SBP \<140 mmHg and DBP \<90 mmHg but not normal. Grade 1 hypertension: SBP \<160 mmHg and DBP \<100 mmHg but not high-normal, Grade 2 hypertension: SBP \<180 mmHg and DBP \<110 mmHg but not grade 1, Grade 3 hypertension: SBP \>=180 mmHg or DBP \>=110 mmHg.

Time frame: weeks 4, 8 and 12

Population: FAS with non-missing data

ArmMeasureGroupValue (NUMBER)
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeBP optimal at week 4 (N=482)4.1 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeBP normal at week 4 (N=482)19.7 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeBP high-normal at week 4 (N=482)30.5 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeGrade 1 hypertension at week 4 (N=482)39.0 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeGrade 2 hypertension at week 4 (N=482)6.2 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeGrade 3 hypertension at week 4 (N=482)0.4 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeBP optimal at week 8 (N=487)5.5 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeBP normal at week 8 (N=487)22.2 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeBP high-normal at week 8 (N=487)40.0 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeGrade 1 hypertension at week 8 (N=487)27.7 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeGrade 2 hypertension at week 8 (N=487)4.3 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeGrade 3 hypertension at week 8 (N=487)0.2 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeBP optimal at week 12 (N=487)4.5 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeBP normal at week 12 (N=487)28.5 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeBP high-normal at week 12 (N=487)35.5 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeGrade 1 hypertension at week 12 (N=487)27.1 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeGrade 2 hypertension at week 12 (N=487)4.1 Percentage of participants
T80/A5Percentage of Patients in Blood Pressure Categories Over TimeGrade 3 hypertension at week 12 (N=487)0.2 Percentage of participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026