This seamless two-stage phase II/III clinical trial aims to evaluate the efficacy and safety of a novel focused power ultrasound mediated inferior perirenal adipose tissue modification therapy for essential hypertension. Stage 1 is a phase II, multicenter, open-label, randomized trial to determine the optimal treatment strategy. Stage 2 is a phase III, multicenter, randomized, double-blind trial investigating the efficacy and safety of optimal treatment strategy compared to sham control.
The increase of visceral fat is closely related to the occurrence of hypertension, and it is one of the main independent risk factors of hypertension. Visceral fat has been recognized as an important endocrine organ, and a variety of factors secreted by visceral fat lead to an increased risk of cardiovascular disease. Peri-renal fat is a special type of visceral fat which is different from other type of visceral fat in histology, physiology, and functions. The positon of peri-renal fat is more stable than other visceral fat, which might be influenced by breath or body position changes. Studies have found that perirenal fat is an early predictor of ASCVD, and its accumulation is closely related to the occurrence and development of ASCVD. Therefore, the reduction or modification of visceral fat, especially peri-renal fat, has a sufficient scientific basis for the treatment of hypertension. In the investigators' previous experiments, this novel focused power ultrasound can rapidly and efficiently promote the perirenal adipose tissue fibrosis and control the blood pressure in the model of swine. Moreover, the investigators performed a single arm, small sample study to investigate the feasibility of the novel focused power ultrasound to modify the inferior perirenal adipose tissue in human volunteers, showing that this kind of method was feasible and safe. This seamless two-stage phase II/III clinical trial aims to evaluate the efficacy and safety of a novel focused power ultrasound mediated inferior perirenal adipose tissue modification therapy for essential hypertension. In Stage 1, 30 participants will be 1:1:1 randomly allocated to 3 intervention groups (single treatment group, consecutive treatment group A, and consecutive treatment group B). The optimal treatment strategy will be selected based on the decrease of blood pressure and safety evaluation and proceed to Stage 2. In Stage 2, participants will be randomly assigned to intervention group (optimal treatment strategy selected formerly in Stage 1) and sham control group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
30
This novel focused power ultrasound is an externally delivered, completely noninvasive focused therapeutic ultrasound device. It is capable of focusing the resulting ultrasound beam to a small "cigar"-shaped volume and monitoring the temperature of the target area, which leads to the rapid elevation of the peri-renal adipose tissue temperature and the destruction of target tissue eventually.
Participants will receive the sham control therapy(including peri-renal fat ultrasonic measurement and localization,focused ultrasound treatment parameters setting),however,without initiating the focused ultrasound equipment.
The Affiliated Jiangning Hospital of Nanjing Medical University
Nanjing, Jiangsu, China
RECRUITINGThe first Affiliated Hospital of Nanjing Medical University
Nanjing, Jiangsu, China
RECRUITINGAffiliated Hospital of Nantong University
Nantong, Jiangsu, China
RECRUITINGSuzhou Municipal Hospital
Suzhou, Jiangsu, China
RECRUITINGAmbulatory Blood Pressure
Changes of mean systolic blood pressure measured by 24-hour ambulatory blood pressure monitoring at 1-month compared with baseline
Time frame: From baseline to 1 month post-procedure
Ambulatory Blood Pressure
Changes of mean systolic blood pressure measured by 24-hour ambulatory blood pressure monitoring at 3-month compared with baseline
Time frame: From baseline to 3 month post-procedure
Office Systolic Blood Pressure
Changes of office systolic blood pressure at 1-month compared with baseline
Time frame: From baseline to 1 month post-procedure
Office Systolic Blood Pressure
Changes of office systolic blood pressure at 3-month compared with baseline
Time frame: From baseline to 3 month post-procedure
Ambulatory Blood Pressure
Changes of mean diastolic blood pressure measured by 24-hour ambulatory blood pressure monitoring at 1-month compared with baseline
Time frame: From baseline to 1 month post-procedure
Ambulatory Blood Pressure
Changes of mean diastolic blood pressure measured by 24-hour ambulatory blood pressure monitoring at 3-month compared with baseline
Time frame: From baseline to 3 month post-procedure
Home Blood Pressure
Changes of home blood pressure at 1-month compared with baseline
Time frame: From baseline to 1 month post-procedure
Home Blood Pressure
Changes of home blood pressure at 3-month compared with baseline
Time frame: From baseline to 3 month post-procedure
Blood pressure control rate
The control rate of blood pressure (defined as office systolic blood pressure\<140/90mmHg) at 3-month
Time frame: From baseline to 3 month post-procedure
Antihypertensive drug load index
Changes of antihypertensive drug load index at 1-month and 3-month compared with baseline
Time frame: From baseline to 1 month and 3 month post-procedure
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.