NCT02593110

Brief Summary

The TELEX trial will establish whether telmisartan alone improves walking performance in people with peripheral artery disease (PAD). The TELEX trial will also determine whether telmisartan plus supervised exercise improves walking performance more than either therapy alone. TELEX is a randomized controlled clinical trial (2 x 2 factorial design) of 112 participants with PAD randomized to one of four arms: Group A: telmisartan + supervised exercise therapy; Group B: telmisartan + a "no exercise" control group; Group C: placebo + supervised exercise therapy; and Group D: placebo + a "no exercise" control group.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
114

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2016

Longer than P75 for not_applicable

Geographic Reach
1 country

3 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 27, 2015

Completed
3 days until next milestone

First Posted

Study publicly available on registry

October 30, 2015

Completed
2 months until next milestone

Study Start

First participant enrolled

January 4, 2016

Completed
6.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 6, 2022

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

June 15, 2022

Completed
7 months until next milestone

Results Posted

Study results publicly available

January 11, 2023

Completed
Last Updated

January 11, 2023

Status Verified

December 1, 2022

Enrollment Period

6.3 years

First QC Date

October 27, 2015

Results QC Date

November 14, 2022

Last Update Submit

December 15, 2022

Conditions

Outcome Measures

Primary Outcomes (1)

  • Six-minute Walk Performance

    We will determine whether telmisartan therapy with or without exercise improves six-minute walk distance at 6-month follow-up, compared to placebo with or without exercise (i.e. two group comparisons of all participants randomized to telmisartan vs. all participants randomized to placebo).

    Change from baseline to six-month follow-up

Secondary Outcomes (5)

  • Maximal Treadmill Walking Distance

    Change from baseline to six-month follow-up

  • Walking Impairment Questionnaire (WIQ) Distance Score

    Change from baseline to six-month follow-up

  • SF-36 Physical Functioning Score

    Change from baseline to six-month follow-up

  • Walking Impairment Questionnaire (WIQ) Speed Score

    Change from baseline to six-month follow-up

  • Walking Impairment Questionnaire (WIQ) Stair-climbing Score

    Change from baseline to six-month follow-up

Study Arms (4)

Telmisartan + Supervised Treadmill Exercise Therapy

ACTIVE COMPARATOR

Participants in this group will receive both daily telmisartan and supervised treadmill exercise three days weekly for six months.

Behavioral: Supervised Treadmill Exercise TherapyDrug: Telmisartan

Telmisartan + "No Exercise" Control Group

ACTIVE COMPARATOR

Participants in this group will receive daily telmisartan and attend weekly educational lectures at the medical center for six months.

Drug: TelmisartanOther: "No exercise" control group

Placebo + Supervised Treadmill Exercise Therapy

ACTIVE COMPARATOR

Participants randomized to this group will receive daily placebo and supervised treadmill exercise three times weekly for six months.

Behavioral: Supervised Treadmill Exercise TherapyDrug: Placebo

Placebo + "No Exercise" Control Group

PLACEBO COMPARATOR

Participants randomized to this group will receive daily placebo and health education lectures weekly for six months.

Other: "No exercise" control groupDrug: Placebo

Interventions

Participants randomized to the exercise intervention will receive supervised treadmill exercise three times weekly for six months.

Also known as: Treadmill exercise
Placebo + Supervised Treadmill Exercise TherapyTelmisartan + Supervised Treadmill Exercise Therapy

Participants randomized to the telmisartan arm of the study will take 20 mg or 40 mg of telmisartan daily based on the results of their study run-in. Participants will have their dose increased to up to 80 mg as tolerated.

Also known as: Micardis
Telmisartan + "No Exercise" Control GroupTelmisartan + Supervised Treadmill Exercise Therapy

Participants randomized to the attention control group will attend weekly one-hour educational sessions at Northwestern University for six months.

Also known as: Attention control group
Placebo + "No Exercise" Control GroupTelmisartan + "No Exercise" Control Group
Placebo + "No Exercise" Control GroupPlacebo + Supervised Treadmill Exercise Therapy

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may not qualify if:

  • Above or below knee amputation, critical limb ischemia, wheelchair confinement, inability to walk without a walker, or current foot ulcer.
  • Walking is limited by a condition other than PAD.
  • \> Class II NYHA heart failure or angina, increase in angina, angina at rest, or abnormal baseline treadmill stress test. Potential participants may become eligible following an abnormal baseline treadmill stress test if they have evidence of an absence of coronary ischemia based on testing with their own physician.
  • Currently taking an angiotensin receptor blocker or an ACE inhibitor or use of these medications in the past three months.
  • Currently taking aliskiren (Tekturna).
  • Blood pressure \< 100/50 at baseline or potassium \> 5.0 meq/L at baseline.
  • Blood pressure \< 100/50 after run-in or potassium \>= 5.5 meq/L at the end of run-in.
  • Severe hepatic impairment defined by two or more liver function enzyme values greater than 2.5 the upper limit of normal.
  • Acute decline in renal function on telmisartan, defined as a 30% or greater decline in eGFR following the two-week run-in as compared to baseline. If the participant had a baseline eGFR performed by his/her physician within two months of the baseline eGFR for the TELEX trial, the participant's physician's eGFR may be considered the baseline measure, at the study principal investigator's discretion.
  • Allergy to ARBs.
  • Failure to successfully complete the 2-week study run-in, defined as failing to attend the health education and treadmill exercise run-in sessions and/or failing to take the study medication daily for 10 or more days in the two-week period (i.e. one pill per day for \> 10 days out of the 14 day run-in period).
  • Surgery including lower extremity revascularization, coronary revascularization with stenting, or orthopedic surgery during the past 3 months or anticipated in the next 6 months or myocardial infarction or stroke in the past 3 months.
  • Major medical illness including renal disease requiring dialysis, lung disease requiring oxygen, Parkinson's disease, a life-threatening illness with life expectancy less than six months, or cancer requiring treatment in the previous two years. \[NOTE: potential participants may still qualify if they have had treatment for an early stage cancer in the past two years and the prognosis is excellent. Participants who only use oxygen at night may still qualify.\]
  • MMSE score \< 23 or dementia.
  • Currently walking regularly for exercise at a level similar to the study intervention.
  • +4 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Northwestern University

Chicago, Illinois, 60611, United States

Location

Tulane University

New Orleans, Louisiana, 70112, United States

Location

Ochsner Medical Center

New Orleans, Louisiana, 70121, United States

Location

Related Publications (1)

  • McDermott MM, Bazzano L, Peterson CA, Sufit R, Ferrucci L, Domanchuk K, Zhao L, Polonsky TS, Zhang D, Lloyd-Jones D, Leeuwenburgh C, Guralnik JM, Kibbe MR, Kosmac K, Criqui MH, Tian L. Effect of Telmisartan on Walking Performance in Patients With Lower Extremity Peripheral Artery Disease: The TELEX Randomized Clinical Trial. JAMA. 2022 Oct 4;328(13):1315-1325. doi: 10.1001/jama.2022.16797.

MeSH Terms

Conditions

Peripheral Arterial Disease

Interventions

Telmisartan

Condition Hierarchy (Ancestors)

AtherosclerosisArteriosclerosisArterial Occlusive DiseasesVascular DiseasesCardiovascular DiseasesPeripheral Vascular Diseases

Intervention Hierarchy (Ancestors)

Biphenyl CompoundsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsBenzimidazolesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic Compounds

Results Point of Contact

Title
Mary McDermott MD
Organization
Northwestern University

Study Officials

  • Mary McDermott, MD

    Northwestern University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Jeremiah Stamler Professor

Study Record Dates

First Submitted

October 27, 2015

First Posted

October 30, 2015

Study Start

January 4, 2016

Primary Completion

May 6, 2022

Study Completion

June 15, 2022

Last Updated

January 11, 2023

Results First Posted

January 11, 2023

Record last verified: 2022-12

Data Sharing

IPD Sharing
Will not share

Locations