This CLAZ696B11302 study is composed of two parts; the Core part including double-blind period, and the open-label extension (OLE) part which is an open-label extension of the Core part. The purpose of the Core part is to demonstrate that LCZ696 (LCZ) when used in combination with amlodipine (AML), denoted as LCZ/AML, will provide greater blood pressure lowering benefit compared to LCZ monotherapy in patients with grade 1 and 2 hypertension not adequately controlled with LCZ monotherapy. The purpose of the OLE part is to assess the long-term safety, tolerability and efficacy of the treatment with LCZ/AML.
This study is designed to provide efficacy and safety data for combinations of LCZ 200 mg and AML (2.5 mg, 5 mg or 10 mg) as compared to LCZ monotherapy in patients with grade 1 and 2 hypertension not adequately controlled with LCZ monotherapy, and also the long-term safety, tolerability and efficacy of the treatment with LCZ/AML. The Core part is a multicenter, randomized, double-blind, parallel-group, active-controlled study which is comprised of the following three periods: Screening / washout period, Single-blind active run-in period, Double-blind treatment period (8 weeks). A 52 week, open-label extension part will be conducted following the completion of the Core part. Those participants that complete the Core part without permanent study drug discontinuation will be offered continued participation in an additional 1 year safety extension to the protocol. Of the patients completed the Core part, approximately 278 participants who are eligible and agree to participate and sign a new informed consent form will start the OLE part, and receive the open-label LCZ/AML combination drug through the OLE part. At start of the OLE part, all participants will be switched to the open-label LCZ/AML 200 mg/5 mg combination drug from double-blinded study medication. After 4 weeks of OLE part, the dosage will be titrated up to LCZ/AML 200 mg/10 mg if an adequate control in blood pressure is not achieved \[msSBP ≥ 130 mmHg or msDBP ≥ 80 mmHg, or the Investigator's judgement basically in accordance with the current local hypertension treatment guideline (JSH2019)\] and when there is no safety concern on up-titration judged by the Investigator. If the blood pressure is controlled optimally, the participants will continue to receive LCZ/AML 200 mg/5 mg. Down-titration from LCZ/AML 200 mg/5 mg to LCZ/AML 200 mg/2.5 mg is permitted after the start of OLE part if participants are having difficulty with the current treatment of LCZ/AML 200 mg/5 mg due to adverse events (AEs) etc. Dose adjustment (up or down-titration) is allowed if participants meet the criteria for dose adjustment (the same defined above as up-titration and down-titration). The Investigators should maintain the maximum tolerated dose as much as possible after 8 weeks of OLE part. Thiazide diuretics/thiazide-like diuretics are allowed as rescue medication(s) at the investigator's discretion on and after 8 weeks of OLE part, if blood pressure is not adequately controlled even with LCZ/AML 200 mg/10 mg or maximum tolerated dose and with no signs of hypovolemia. Initial dose of the concomitant diuretics should be low, then the dose can be adjusted.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
718
Novartis Investigative Site
Nagoya, Aichi-ken, Japan
Novartis Investigative Site
Nagoya, Aichi-ken, Japan
Novartis Investigative Site
Nagoya, Aichi-ken, Japan
Novartis Investigative Site
Nagoya, Aichi-ken, Japan
Novartis Investigative Site
Itoshima, Fukuoka, Japan
Novartis Investigative Site
[Core Part] Change from baseline to Week 8 in msSBP
Change from baseline to Week 8 in mean sitting systolic blood pressure (msSBP)
Time frame: Baseline, Week 8
[Core Part] Change from baseline to Week 8 in maSBP
Change from baseline to Week 8 in mean 24-hour ambulatory systolic blood pressure (maSBP)
Time frame: Baseline, Week 8
[Core Part] Proportion of patients achieving a blood pressure control after 8 weeks of treatment
Proportion of patients achieving a blood pressure control (msSBP \<140 mmHg and msDBP \<90 mmHg) after 8 weeks of treatment
Time frame: 8 weeks
[Core Part] Change from baseline to Week 8 in msDBP
Change from baseline to Week 8 in mean sitting diastolic blood pressure (msDBP)
Time frame: Baseline, Week 8
[Core Part] Change from baseline to Week 8 in maDBP
Change from baseline to Week 8 in mean 24-hour ambulatory diastolic blood pressure (maDBP)
Time frame: Baseline, Week 8
[Core Part] Proportion of patients achieving a msSBP response after 8 weeks of treatment
Proportion of patients achieving a msSBP response (\<140 mmHg or a reduction ≥20 mmHg from baseline) after 8 weeks of treatment
Time frame: 8 weeks
[Core Part] Proportion of patients achieving a msDBP response after 8 weeks of treatment
Proportion of patients achieving a msDBP response (\<90 mmHg or a reduction ≥10 mmHg from baseline) after 8 weeks of treatment
Time frame: 8 weeks
[Core Part] Change from baseline to Week 8 in daytime, nighttime and early morning maSBP
Change from baseline to Week 8 in daytime, nighttime and early morning maSBP
Time frame: Baseline, Week 8
[Core Part] Change from baseline to Week 8 in daytime, nighttime and early morning maDBP
Change from baseline to Week 8 in daytime, nighttime and early morning maDBP
Time frame: Baseline, Week 8
[Core Part] Number of patients with treatment-emergent adverse events
Number of patients experiencing treatment-emergent adverse events including (but not limited to) any unfavorable and unintended signs, symptoms or disease, abnormal vital signs, electrocardiogram data, safety lab measurements that induce clinical signs or symptoms, are considered clinically significant or require therapy
Time frame: Up to 8 weeks
[OLE Part] Number of patients with treatment-emergent adverse events
Number of patients experiencing treatment-emergent adverse events including (but not limited to) any unfavorable and unintended signs, symptoms or disease, abnormal vital signs, electrocardiogram data, safety lab measurements that induce clinical signs or symptoms, are considered clinically significant or require therapy
Time frame: Up to 52 weeks
[OLE Part] Change from baseline in msSBP and msDBP
Change from baseline in msSBP and msDBP by visit in OLE part
Time frame: Baseline, Week 4, Week 8, Week 13, Week 26, Week 39, and Week 52 of OLE part
[OLE Part] Proportion of patients achieving blood pressure control, msSBP response and msDBP response
Proportion of patients achieving blood pressure control (msSBP \<140 mmHg and msDBP \<90 mmHg), msSBP response (\<140 mmHg or a reduction ≥20 mmHg from baseline) and msDBP response (\<90 mmHg or a reduction ≥10 mmHg from baseline) by visit
Time frame: Over 52 weeks
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Chitose, Hokkaido, Japan
Novartis Investigative Site
Sapporo, Hokkaido, Japan
Novartis Investigative Site
Sapporo, Hokkaido, Japan
Novartis Investigative Site
Sapporo, Hokkaido, Japan
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Akashi, Hyōgo, Japan
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