Study of Nifedipine GITS and Candesartan Combination Compared to Monotherapy in Patients With Essential Hypertension
DISTINCT
A Multicenter, Multifactorial, Randomized, Double-Blind, Placebo-Controlled Dose-Finding Study of Nifedipine GITS and Candesartan in Combination Compared to Monotherapy in Adult Patients With Essential Hypertension
2 other identifiers
interventional
1,381
13 countries
157
Brief Summary
The purpose of this study is to determine the blood pressure lowering responses of various dose combinations of nifedipine GITS and candesartan as compared to treatment with each component on their own (monotherapy) and placebo (a look-alike tablet without active ingredient). The drugs - nifedipine GITS and candesartan - which are being investigated are currently approved for use in patients with essential hypertension alone or together with other antihypertensive drugs (combination therapy), but the optimal dose of nifedipine GITS and candesartan used together in the treatment of essential hypertension has not been established yet. In this study patients will be treated with various doses of nifedipine GITS and/or candesartan or placebo. These different regimens will be administered once a day and will be assessed based on their blood pressure lowering effects (mean sitting diastolic blood pressure) in subjects with mild to moderate essential hypertension.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for phase_2
Started Apr 2011
Shorter than P25 for phase_2
157 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
February 24, 2011
CompletedFirst Posted
Study publicly available on registry
February 25, 2011
CompletedStudy Start
First participant enrolled
April 1, 2011
CompletedPrimary Completion
Last participant's last visit for primary outcome
May 1, 2012
CompletedStudy Completion
Last participant's last visit for all outcomes
May 1, 2012
CompletedApril 18, 2017
April 1, 2017
1.1 years
February 24, 2011
April 14, 2017
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
The primary efficacy variable is the change from baseline in mean seated diastolic blood pressure (MSDBP) at Week 8
Baseline taken at Visit 1; primary outcome variable assesed at 8 weeks
Secondary Outcomes (5)
Change in mean seated systolic blood pressure (MSSBP) at Week 8
8 weeks
Control rate at Week 8
8 weeks
Response rate at Week 8
8 weeks
Peripheral Edema
8 weeks
Time to achieve first BP control
8 weeks
Study Arms (16)
Nifedipine GITS 20 mg
EXPERIMENTALSubjects received 20 mg of nifedipine GITS (single tablet) monotherapy once daily for 8 weeks along with 2 placebo tablets and 1 placebo capsule
Nifedipine GITS 30 mg
EXPERIMENTALSubjects received 30 mg of nifedipine GITS (single tablet) monotherapy once daily for 8 weeks along with 2 placebo tablets and 1 placebo capsule
Nifedipine GITS 60 mg
EXPERIMENTALSubjects received 60 mg of nifedipine GITS (single tablet) monotherapy once daily for 8 weeks along with 2 placebo tablets and 1 placebo capsule
Candesartan cilexetil 4 mg
EXPERIMENTALSubjects received 4 mg of candesartan cilexetil (single capsule) monotherapy once daily for 8 weeks along with 3 placebo tablets
Candesartan cilexetil 8 mg
EXPERIMENTALSubjects received 8 mg of candesartan cilexetil (single capsule) monotherapy once daily for 8 weeks along with 3 placebo tablets
Candesartan cilexetil 16 mg
EXPERIMENTALSubjects received 16 mg of candesartan cilexetil (single capsule) monotherapy once daily for 8 weeks along with 3 placebo tablets
Candesartan cilexetil 32 mg
EXPERIMENTALSubjects received 32 mg of candesartan cilexetil (single capsule) monotherapy once daily for 8 weeks along with 3 placebo tablets
Nifedipine/candesartan 20/4 mg
EXPERIMENTALSubjects received the combination of 20 mg of nifedipine GITS/4 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
Nifedipine/candesartan 20/8 mg
EXPERIMENTALSubjects received the combination of 20 mg of nifedipine GITS/8 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
Nifedipine/candesartan 20/16 mg
EXPERIMENTALSubjects received the combination of 20 mg of nifedipine GITS/16 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
Nifedipine/candesartan 30/8 mg
EXPERIMENTALSubjects received the combination of 30 mg of nifedipine GITS/8 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
Nifedipine/candesartan 30/16 mg
EXPERIMENTALSubjects received the combination of 30 mg of nifedipine GITS/16 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
Nifedipine/candesartan 30/32 mg
EXPERIMENTALSubjects received the combination of 30 mg of nifedipine GITS/32 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
Nifedipine/candesartan 60/16 mg
EXPERIMENTALSubjects received the combination of 60 mg of nifedipine GITS/16 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
Nifedipine/candesartan 60/32 mg
EXPERIMENTALSubjects received the combination of 60 mg of nifedipine GITS/32 mg of candesartan cilexetil once daily for 8 weeks along with 2 placebo tablets
Placebo
PLACEBO COMPARATORSubjects received placebo (3 tablets and 1 capsule) once daily for 8 weeks
Interventions
4 mg of candesartan as capsule
8 mg candesartan as capsule
20 mg nifedipine as tablet
30 mg nifedipine as tablet
60 mg nifedipine as tablet
3 different placebo tablets corresponding nifedipine doses and 1 placebo capsule corresponding to candesartan doses
16 mg of candesartan as capsule
32 mg of candesartan as capsule
Eligibility Criteria
You may qualify if:
- Male and female subjects 18 years or older. Female subjects must be either post-menopausal for one year, surgically sterile, or using an effective contraceptive method. Hormonal contraceptive use is disallowed.
- Subjects must have mild to moderate essential hypertension (Grade 1 and 2 WHO classifications) as measured by calibrated standard sphygmomanometer. (MSDBP of ≥90 mmHg and \< 110 mmHg at Visit 1 (placebo run-in), and MSDBP of ≥95 mmHg and \< 110 mmHg at visit 2 (randomization)
- Subjects must have an absolute difference in their MSDBP of less than 10 mmHg between Visit 1 (placebo run- in) and Visit 2 (randomization).
You may not qualify if:
- Severe hypertension (Grade 3 WHO classification; MSDBP ≥110 mmHg and/or MSSBP ≥ 180 mmHg)
- Inability to washout of antihypertensive drugs (even if prescribed for another indication) safely for a period of 14 weeks.
- History of hypertensive retinopathy - known Keith-Wagener Grade III or IV
- History of hypertensive encephalopathy
- Cerebrovascular ischemic event (stroke, transient ischemic attack \[TIA\])within the previous 12 months
- History of intracerebral hemorrhage or subarachnoid hemorrhage
- Evidence of secondary hypertension such as coarchation of the aorta, pheochromocytoms, hypersaldosteronism, etc.
- Type I diabetes mellitus (DM) or poorly controlled DM Type II as evidenced by a glycosylated hemoglobin \[HbA1C\] of greater than 9% on visit 1.
- Allergies or known intolerance to one of the investigational drugs/drug class or to one of their ingredients
- Any history of heart failure, New York Heart Association (NYHA) classification III or IV
- Severe coronary heart disease as manifest by a history of myocardial infarction or unstable angina in the last 6 months prior to visit 1.
- Clinically significant cardiac valvular disease
- History of malignancy in the last 5 years, excluding basal or skin cancer
- Uncorrected hypokalemia or hyperkalemia: potassium outside 3.0-5.0 mmol/L
- Surgical or medical conditions that might alter the metabolism, excretion or distribution or absorption of any drug
- +18 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Bayerlead
Study Sites (157)
Unknown Facility
Mobile, Alabama, 36617, United States
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Los Angeles, California, 90057, United States
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Coral Gables, Florida, 33114-4192, United States
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Deerfield Beach, Florida, 33321, United States
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Deerfield Beach, Florida, 33441, United States
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Fort Lauderdale, Florida, 33309, United States
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Jacksonville, Florida, 32216, United States
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West Palm Beach, Florida, 33409, United States
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Atlanta, Georgia, 30338, United States
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Valparaiso, Indiana, 46383, United States
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Charlotte, North Carolina, 28209, United States
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Harrisburg, North Carolina, 28075, United States
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Raleigh, North Carolina, 27609, United States
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Salisbury, North Carolina, 28144, United States
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Cincinnati, Ohio, 45224, United States
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Philadelphia, Pennsylvania, 19142, United States
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Greenville, South Carolina, 29615, United States
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Mt. Pleasant, South Carolina, 29464, United States
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Dallas, Texas, 75230, United States
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San Antonio, Texas, 78205, United States
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Salt Lake City, Utah, 84109, United States
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Salt Lake City, Utah, 84121, United States
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Kenosha, Wisconsin, 53142, United States
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Bahía Blanca, Buenos Aires, 8000, Argentina
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Quilmes, Buenos Aires, Argentina
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Zárate, Buenos Aires, B2800DGH, Argentina
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Buenos Aires, Ciudad Auton. de Buenos Aires, 1405, Argentina
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Buenos Aires, Ciudad Auton. de Buenos Aires, C1280AEB, Argentina
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Buenos Aires, Ciudad Auton. de Buenos Aires, C1425AWC, Argentina
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Buenos Aires, Ciudad Auton. de Buenos Aires, C1425DES, Argentina
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Buenos Aires, Ciudad Auton. de Buenos Aires, C1430AAQ, Argentina
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Buenos Aires, Ciudad Auton. de Buenos Aires, C1440AAD, Argentina
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Corrientes, Corrientes Province, 3400, Argentina
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Córdoba, Córdoba Province, 5000, Argentina
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Córdoba, Córdoba Province, X5002AOQ, Argentina
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Rosario, Santa Fe Province, 2000, Argentina
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Santa Fe, Santa Fe Province, 3000, Argentina
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Wetteren, Oost-Vlaanderen, 9230, Belgium
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De Pinte, 9840, Belgium
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Deurne, 2100, Belgium
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Ham, 3545, Belgium
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Fortaleza, Ceará, 60120-021, Brazil
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Brasília, Federal District, 71265 009, Brazil
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Goiânia, Goiás, 74605-050, Brazil
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Rio de Janeiro, Rio de Janeiro, 22271-100, Brazil
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Campinas, São Paulo, 13010-001, Brazil
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Campinas, São Paulo, 13060904, Brazil
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São Paulo, São Paulo, 01244-030, Brazil
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São Paulo, São Paulo, 04025-011, Brazil
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Langley, British Columbia, V3A 4H9, Canada
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St. John's, Newfoundland and Labrador, A1A 3R5, Canada
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St. John's, Newfoundland and Labrador, A1E 2E2, Canada
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Brampton, Ontario, L6T 0G1, Canada
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Corunna, Ontario, N0N 1G0, Canada
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Downsview, Ontario, M3J 1N2, Canada
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Etobicoke, Ontario, M8V 3X8, Canada
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London, Ontario, N5W 6A2, Canada
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London, Ontario, N5Y 5K7, Canada
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Newmarket, Ontario, L3Y 5G8, Canada
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Sarnia, Ontario, N7T 4X3, Canada
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Strathroy, Ontario, N7G 1Y7, Canada
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Toronto, Ontario, M9V 4B4, Canada
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Toronto, Ontario, M9W 4L6, Canada
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Montreal, Quebec, H4N 2W2, Canada
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Chieti, Abruzzo, 66013, Italy
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Bologna, Emilia-Romagna, 40138, Italy
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Trieste, Friuli Venezia Giulia, 34149, Italy
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Milan, Lombardy, 20132, Italy
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Pavia, Lombardy, 27100, Italy
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Sassari, Sardinia, 07100, Italy
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Pisa, Tuscany, 56124, Italy
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Perugia, Umbria, 06129, Italy
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Mercato San Severino, 84085, Italy
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Alytus, LT-62381, Lithuania
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Kaunas, LT-49387, Lithuania
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Kaunas, LT-50009, Lithuania
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Vilnius, LT-08661, Lithuania
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Moscow, 115432, Russia
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Moscow, 117997, Russia
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Moscow, 119048, Russia
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Moscow, 119415, Russia
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Moscow, 125284, Russia
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Saint Petersburg, 195112, Russia
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Saint Petersburg, 195271, Russia
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Saint Petersburg, 196247, Russia
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Saint Petersburg, 197022, Russia
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Saint Petersburg, 197341, Russia
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Saint Petersburg, 198013, Russia
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Saint Petersburg, 198205, Russia
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Saint Petersburg, 199106, Russia
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Smolensk, 214019, Russia
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Port Elizabeth, Eastern Cape, 6014, South Africa
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Johannesburg, Gauteng, South Africa
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Petoria, Gauteng, South Africa
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Roodepoort, Gauteng, 1724, South Africa
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Durban, KwaZulu-Natal, 4037, South Africa
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Witbank, Mpumalanga, 1035, South Africa
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Somerset West, Western Cape, 7130, South Africa
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Stellenbosch, Western Cape, 7505, South Africa
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Daejeon, Daejeon Gwang''yeogsi, 301-723, South Korea
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Wŏnju, Gang''weondo, 220-701, South Korea
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Anyang-si, Gyeonggido, 431-070, South Korea
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Goyang-si, Gyeonggido, 410-719, South Korea
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Goyang-si, Gyeonggido, 410-773, South Korea
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Goyang-si, Gyeonggido, 411-706, South Korea
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Goyang-si, Gyeonggido, 412-270, South Korea
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Uijeongbu-si, Gyeonggido, 480-130, South Korea
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Seoul, Seoul Teugbyeolsi, 135-720, South Korea
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Seoul, Seoul Teugbyeolsi, 150-713, South Korea
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Seoul, Seoul Teugbyeolsi, 152-703, South Korea
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Seoul, Seoul Teugbyeolsi, 156-755, South Korea
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Seoul, Seoul Teugbyeolsi, 158 710, South Korea
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Busan, 602-793, South Korea
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Chungchungbuk-do, 361-711, South Korea
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Seoul, 110-744, South Korea
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Seoul, 120-752, South Korea
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Seoul, 133-792, South Korea
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Seoul, 150-950, South Korea
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Seoul, 156-707, South Korea
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Santiago de Compostela, A Coruña, 15706, Spain
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Benidorm, Alicante, 03503, Spain
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Petrel, Alicante, 03610, Spain
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Barcelona, Barcelona, 08036, Spain
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Hostalets de Balenyà, Barcelona, 08550, Spain
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Peralada, Girona, 17491, Spain
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Granada, Granada, 18012, Spain
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Huelva, Huelva, 21003, Spain
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Oviedo, Principality of Asturias, 33013, Spain
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Valencia, Valencia, 46006, Spain
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Dnipropetrovsk, 49060, Ukraine
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Kharkiv, 61176, Ukraine
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Kiev, 01 151, Ukraine
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Kiev, 01151, Ukraine
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Kiev, 02 091, Ukraine
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Kiev, 02660, Ukraine
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Kiev, 03680, Ukraine
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Vinnitsa, 2108, Ukraine
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Zaporizhzhya, 69118, Ukraine
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Zhytomyr, 10002, Ukraine
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Bath, Avon, BA2 4BY, United Kingdom
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Fowey, Cornwall, PL23 1DT, United Kingdom
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Penzance, Cornwall, TR18 4JH, United Kingdom
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Penzance, Cornwall, TR19 7HX, United Kingdom
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St Austell, Cornwall, PL26 7RL, United Kingdom
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Chesterfield, Derbyshire, S40 4AA, United Kingdom
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Glasgow, Glasgow City, G20 0XA, United Kingdom
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Glasgow, Glasgow City, G20 7LR, United Kingdom
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Blackpool, Lancashire, FY3 7EN, United Kingdom
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Bath, Somerset, BA3 2UH, United Kingdom
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Addlestone, Surrey, KT15 2BH, United Kingdom
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Coventry, Warwickshire, CV6 4DD, United Kingdom
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Royal Leamington Spa, Warwickshire, CV32 4RA, United Kingdom
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Chippenham, Wiltshire, SN15 2SB, United Kingdom
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Trowbridge, Wiltshire, BA14 8QA, United Kingdom
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Westbury, Wiltshire, BA13 3JD, United Kingdom
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Bath, BA11 2FH, United Kingdom
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Bath, BA2 4JT, United Kingdom
Related Publications (2)
Kjeldsen SE, Cha G, Villa G, Mancia G; DISTINCT Investigators. Nifedipine GITS/Candesartan Combination Therapy Lowers Blood Pressure Across Different Baseline Systolic and Diastolic Blood Pressure Categories: DISTINCT Study Subanalyses. J Clin Pharmacol. 2016 Sep;56(9):1120-9. doi: 10.1002/jcph.712. Epub 2016 Mar 7.
PMID: 26829251RESULTKjeldsen SE, Sica D, Haller H, Cha G, Gil-Extremera B, Harvey P, Heyvaert F, Lewin AJ, Villa G, Mancia G; DISTINCT Investigators. Nifedipine plus candesartan combination increases blood pressure control regardless of race and improves the side effect profile: DISTINCT randomized trial results. J Hypertens. 2014 Dec;32(12):2488-98; discussion 2498. doi: 10.1097/HJH.0000000000000331.
PMID: 25144296DERIVED
Related Links
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- STUDY DIRECTOR
Bayer Study Director
Bayer
Study Design
- Study Type
- interventional
- Phase
- phase 2
- Allocation
- RANDOMIZED
- Masking
- QUADRUPLE
- Who Masked
- PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- INDUSTRY
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
February 24, 2011
First Posted
February 25, 2011
Study Start
April 1, 2011
Primary Completion
May 1, 2012
Study Completion
May 1, 2012
Last Updated
April 18, 2017
Record last verified: 2017-04