International, Multicenter, Study of One-year, Open-label, Titrated Oral Tolvaptan Tablet Administration in Patients With Chronic Hyponatremia

NCT02449044 | Completed Phase 3 Results

• 1 other identifier: 156-03-244
• Study Type: interventional
• Target: 111
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study will assess the safety of long-term tolvaptan use in patients previously enrolled in shorter-term Phase 3 studies and gather information on the natural history of hyponatremia in the context of tolvaptan therapy and underlying disease states.

Conditions

Hyponatremia

Keywords

Hyponatremia

Outcome Measures

Primary Outcomes (5)

• Participants With Adverse Events (AEs)

  A TEAE was an AE that began after the first injection or was continuous from Baseline and was defined as any new medical problem, or exacerbation of an existing problem, whether or not it was considered drug-related by the study physician. An AE was considered serious if it was fatal; life-threatening; persistently or significantly disabling or incapacitating; required in-subject hospitalization or prolonged hospitalization; a congenital anomaly/birth defect; or other medically significant event that, based upon appropriate medical judgment, may have jeopardized the participant and may have required medical or surgical intervention to prevent the outcomes mentioned above.

  Baseline to Post-Week 214 follow-up visit

• Participants With Laboratory Values Abnormalities Reported as TEAEs

  The laboratory values were one of the primary parameters to measure the safety and tolerability of individual participants. Incidence of TEAEs of potential clinical relevance include abnormal values in serum chemistry, hematology, urinalyses and prolactin tests that were identified based on pre-defined criteria. Any value outside the normal range was flagged for the attention of the study physician who was to indicate whether the value was clinically significant for identifying laboratory values of potential clinical relevance. Participants noted with abnormal laboratory values are reported below.

  Baseline to Post-Week 214 follow-up visit

• Participants With Electrocardiogram (ECG) Related Abnormalities Reported as TEAEs

  The ECG was one of the primary parameters to measure the safety and tolerability of individual participants. Incidence of TEAEs of potential clinical relevance included abnormal values in HR outliers, PR outliers, QRS outliers, QT, QTcB, QTcF that were identified based on pre-defined criteria. Some of the pre-defined criteria for identifying ECG measurements of potential clinical relevance included: For QTcB and QTcF: baseline mean of QTcB and QTcF interval was new onset \>500 msec, 30 - 60 msec, \>60 msec; For QT: new onset \>500 msec; For QRS outliers: \>=25% change from baseline when QRS \>100 msec; PR outliers: \>=25% change from baseline when PR\>200 msec; HR outliers: 25% decrease from baseline and HR \<50 bpm or 25% increase from baseline and HR \>100 bpm. New onset (\>500 msec) in QT, QTcB, or QTcF means a participant who attained a value \>500 msec during treatment period but not at each baseline visit. The ECG-related abnormalities are reported as TEAEs are mentioned below.

  Baseline to Post-Week 214 follow-up visit

• Participants With Vital Signs Abnormalities Reported as Treatment Emergent Adverse Events (TEAEs)

  The vital signs were one of the primary parameters to measure the safety and tolerability of individual participants. Incidence of TEAEs of potential clinical relevance included abnormal values in body temperature, heart rate, systolic and diastolic blood pressure, respiratory rate and weight that were identified based on pre-defined criteria. Criteria for identifying vital signs of potential clinical relevance included: Heart rate, supine: \>= 120 beats per minute (bpm) + increase of ≥15 bpm from Baseline and \<=50 bpm + decrease of \>= 15 bpm; Diastolic Blood Pressure, Supine: \>=105 mmHg + increase of \>=15 mmHg and \<=50 mmHg + decrease of \>=15 mmHg; Systolic Blood Pressure, Supine: \>=180 mmHg + increase of \>=20 mmHg and \<= 90 mmHg + decrease of \>=20 mmHg; Temperature (degree C): Increase of \>=1.1 to \>=38.3C. The vital sign abnormalities were reported as TEAEs are mentioned below.

  Baseline to Post-Week 214 follow-up visit

• Participants With Body Weight Abnormalities Reported as TEAEs

  The body weight evaluation was one of the primary parameters to measure the safety and tolerability of individual participants. Every effort was made to ensure that body weight measurements were performed in a reproducible and consistent manner. The pre-defined criteria was change of ≥7% in body weight for both male and female. Participants were to wear the same type of clothes at each measurement, preferably a gown and no shoes. All body weight measurements were to have been taken post-void.

  Baseline to Post-Week 214 follow-up visit

Secondary Outcomes (11)

• Mean Change From Baseline in Serum Sodium Measurements

  Baseline of parent trial to Week 214

• Change From Baseline in Percentage of Participants With Severe Hyponatremia

  Baseline to Week 214

• Change From Baseline in Percentage of Participants With Mild Hyponatremia

  Baseline to Week 214

• Change From Baseline in Percentage of Participants With Normal Sodium Levels

  Baseline to Week 214

• Percentage of Participants Requiring Prescription of Fluid Restriction

  Baseline to Post-Week 214 follow-up visit

Study Arms (1)

Tolvaptan

EXPERIMENTAL

Enrolled subjects began treatment with 15 mg tolvaptan QD. A titration between target doses of 15 mg, 30 mg, or 60 mg of trial medication was based on the subject's change in serum sodium concentration and clinical tolerance of the trial medication.

Drug: Tolvaptan

Interventions

Tolvaptan DRUG

Once Daily

Tolvaptan

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age greater than or equal to 18 years.
• Ability to provide informed consent or assent.
• Prior successful participation in a tolvaptan hyponatremia trial termination with evidence of continued need or desire for therapy.

You may not qualify if:

• A current medical condition where long-term treatment with an aquaretic agent may present an undue risk to the patient.
• Hyponatremia which is acute, reversible, artifactual or due to conditions not associated with vasopressin excess or likely to respond to aquaretic therapy.
• Hyponatremia due to reversible medical condition or therapy
• Conditions associated with an independent imminent risk of morbidity and mortality
• Conditions which confound the assessment of endpoints.

Sponsors & Collaborators

• Otsuka Pharmaceutical Development & Commercialization, Inc.: lead

Related Publications (1)

• Berl T, Quittnat-Pelletier F, Verbalis JG, Schrier RW, Bichet DG, Ouyang J, Czerwiec FS; SALTWATER Investigators. Oral tolvaptan is safe and effective in chronic hyponatremia. J Am Soc Nephrol. 2010 Apr;21(4):705-12. doi: 10.1681/ASN.2009080857. Epub 2010 Feb 25.

  PMID: 20185637 RESULT

MeSH Terms

Conditions

Hyponatremia

Interventions

Tolvaptan

Condition Hierarchy (Ancestors)

Water-Electrolyte Imbalance; Metabolic Diseases; Nutritional and Metabolic Diseases

Intervention Hierarchy (Ancestors)

Benzazepines; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Heterocyclic Compounds

Results Point of Contact

• Title: Global Medical Affairs
• Organization: Otsuka Pharmaceutical Development and Commercialization, Inc.

800 562-3974

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 14, 2015
• First Posted: May 20, 2015
• Study Start: May 1, 2004
• Primary Completion: October 1, 2009
• Study Completion: October 1, 2009
• Last Updated: January 21, 2016
• Results First Posted: January 21, 2016

Record last verified: 2015-12