NCT03240068

Brief Summary

Peripheral arterial disease (PAD) affects over 8 million individuals in the United States alone. This is a form of atherosclerosis in which plaques preferentially build up inside the arteries of the legs to limit blood flow. These patients are at high risk for heart attack and stroke, with at least half dying from coronary artery disease. Our understanding of the causes of PAD remains incomplete. The renin-angiotensin hormone system is one mechanism known to contribute to atherosclerosis. Pharmacologic blockade of the hormone angiotensin II is beneficial in forms of atherosclerosis, including peripheral arterial disease, to improve blood vessel damage and functional outcomes. These therapies also increase circulating levels of angiotensin-(1-7), a hormone that dilates blood vessels. Angiotensin-(1-7) improves blood vessel function and reduces inflammation to protect against atherosclerosis in animal models; however, there are no clinical data in patients with atherosclerosis. The overall goal of this project is to examine the cardiovascular effects of angiotensin-(1-7) in PAD.

Trial Health

57
Monitor

Trial Health Score

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

Enrollment
6

participants targeted

Target at below P25 for early_phase_1

Timeline
Completed

Started Sep 2017

Typical duration for early_phase_1

Geographic Reach
1 country

1 active site

Status
terminated

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

August 2, 2017

Completed
2 days until next milestone

First Posted

Study publicly available on registry

August 4, 2017

Completed
28 days until next milestone

Study Start

First participant enrolled

September 1, 2017

Completed
2.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 9, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 9, 2020

Completed
Last Updated

May 3, 2024

Status Verified

May 1, 2024

Enrollment Period

2.5 years

First QC Date

August 2, 2017

Last Update Submit

May 2, 2024

Conditions

Keywords

Renin-Angiotensin SystemInflammationCardiovascularAtherosclerosis

Outcome Measures

Primary Outcomes (2)

  • Leg Blood Flow

    The change in measures of leg blood flow (e.g. femoral blood flow and conductance, calf muscle oxygen saturation) following angiotensin-(1-7) versus saline infusion.

    50 minutes

  • Inflammatory Markers

    The change in blood levels of inflammatory markers C-Reactive Protein and Interleukin-6 following angiotensin-(1-7) versus saline infusion.

    50 minutes

Secondary Outcomes (2)

  • Blood Pressure

    50 minutes

  • Heart Rate

    50 minutes

Other Outcomes (3)

  • Renin-Angiotensin System Hormones

    50 minutes

  • Nitric Oxide Bioavailability

    50 minutes

  • Lipids

    50 minutes

Study Arms (2)

Angiotensin-(1-7)

EXPERIMENTAL

Subjects will receive intravenous infusion of five ascending doses of angiotensin-(1-7). The doses are: 1, 2, 4, 8, and 12 ng/kg/min. Each dose will be maintained for 10 minutes, for a total infusion period of 50 minutes.

Drug: Angiotensin 1-7

Saline

PLACEBO COMPARATOR

Subjects will receive intravenous infusion of saline that is matched in volume to the angiotensin-(1-7) arm. Saline infusion will be maintained for a total infusion period of 50 minutes.

Drug: Saline

Interventions

This is a biologically active hormone of the renin-angiotensin system. It may play a beneficial role in regulation of blood pressure by dilating blood vessels and reducing inflammation.

Also known as: Angiotensin I (1-7), Angiotensin I/II (1-7) Acetate
Angiotensin-(1-7)
SalineDRUG

Normal saline will be used as the placebo comparator.

Also known as: normal saline, 0.9% sodium chloride
Saline

Eligibility Criteria

Age21 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Sex: Male or Female
  • Age: 21-80 years of age
  • Diagnosed with PAD (e.g. ankle-brachial index below 0.9)
  • Fontaine stage II or less (no rest pain)
  • Capable of giving informed consent
  • Fluent in written and spoken English

You may not qualify if:

  • Age less than or equal to 20 years or greater than or equal to 81 years
  • Pregnant or nursing woman
  • Decisional impairment
  • Prisoners
  • Alcohol or drug abuse
  • Evidence of type I or type II diabetes (fasting glucose \>126 mg/dl or use of anti-diabetic medications)
  • History of serious cardiovascular disease (e.g. myocardial infarction within 6 months, symptomatic coronary artery disease, presence of angina pectoris, significant arrhythmia, congestive heart failure, deep vein thrombosis, pulmonary embolism, second or third degree heart block, mitral valve stenosis, aortic stenosis, hypertrophic cardiomyopathy) or cerebrovascular disease (e.g. cerebral hemorrhage, stroke, transient ischemic attack).
  • History or presence of immunological or hematological disease
  • Impaired hepatic function \[aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels \> 2 times the upper limit of normal range)
  • Impaired renal function (serum creatinine \>2.0 mg/dl)
  • Anemia
  • Treatment with serotonin-norepinephrine reuptake inhibitors (SNRI) or norepinephrine transporter (NET) inhibitors
  • Treatment with phosphodiesterase-5 inhibitors
  • Treatment with anticoagulants
  • Treatment with chronic systemic glucocorticoid therapy (\>7 consecutive days in 1 month)
  • +2 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Penn State Milton S. Hershey Medical Center

Hershey, Pennsylvania, 17033, United States

Location

MeSH Terms

Conditions

Peripheral Arterial DiseaseInflammationAtherosclerosis

Interventions

angiotensin I (1-7)AcetatesSodium ChlorideSaline Solution

Condition Hierarchy (Ancestors)

ArteriosclerosisArterial Occlusive DiseasesVascular DiseasesCardiovascular DiseasesPeripheral Vascular DiseasesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Acids, AcyclicCarboxylic AcidsOrganic ChemicalsFatty Acids, VolatileFatty AcidsLipidsChloridesHydrochloric AcidChlorine CompoundsInorganic ChemicalsSodium CompoundsCrystalloid SolutionsIsotonic SolutionsSolutionsPharmaceutical Preparations

Study Officials

  • Amy C Arnold, PhD

    Penn State College of Medicine

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
early phase 1
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

August 2, 2017

First Posted

August 4, 2017

Study Start

September 1, 2017

Primary Completion

March 9, 2020

Study Completion

March 9, 2020

Last Updated

May 3, 2024

Record last verified: 2024-05

Data Sharing

IPD Sharing
Will not share

Locations