This 12-week, randomized, double-blind, placebo-controlled Phase 2 study will evaluate two fixed-dose oral combinations of L-leucine, sildenafil, and metformin (NS-0200) versus matching placebo in adults 18-75 years with hypertension. Approximately 150 subjects will be screened to randomize \~150 (≈50 per arm) with an expected completer population of \~120. The primary objective is to compare change in mean seated systolic blood pressure from baseline (Day 1) to Week 12 (Day 84) for each NS-0200 dose versus placebo. Secondary outcomes include change in seated diastolic blood pressure and change in body weight. Safety will be monitored through adverse events, labs, vital signs, ECGs, and pregnancy testing.
This is a 12-week, randomized, placebo-controlled, double-blind Phase 2 trial of two fixed-dose combinations (FDC) of L-leucine, sildenafil and metformin (NS-0200) versus placebo in adults 18-75 years with seated systolic blood pressure \>130 mmHg who meet inclusion/exclusion criteria. Screening (Visit 1, Day -7) precedes Baseline/Randomization and first dose on Day 1 (Visit 2). Visits occur at Day 28 (Week 4) and Day 56 (Week 8); telephone contacts occur at Days 14, 42, and 70; Study Termination is Day 84 (Week 12). Study medication is self-administered orally BID (30 minutes before meals) as three tablets per dose. Subjects randomized 1:1:1 to placebo or one of two NS-0200 dose levels; stratified by baseline SBP (\<145 vs ≥145 mmHg). Primary analysis compares change in mean seated SBP from Baseline (Day 1) to Day 84 for each active arm versus placebo using mixed-model ANCOVA; missing data handled with multiple imputation. Safety assessments include TEAEs/SAEs, clinical labs, ECGs, vitals, pregnancy testing, and monitoring for lactic acidosis, hypotension and vision changes
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
150
Two tablets 550 mg L-leucine + 250 mg metformin and one tablet 1.0 mg sildenafil per dose; 3 tablets/dose orally BID
Two tablets 550 mg L-leucine + 250 mg metformin and one tablet 4.0 mg sildenafil per dose; 3 tablets/dose orally BID
9.5% microcrystalline cellulose PH 102, 5.0% crospovidone XL 10, 1.0% silica gel (Syloid 244), 0.5% magnesium stearate I MF3V for the leucine-matched placebo; 99.5% Avicel PH200, 0.5% magnesium stearate (w/w) and Opadry II White coating 3% weight gain for the sildenafil matched placebo, self-administered by the patient as 3 tablets taken orally bid within 30 minutes prior to the morning and evening meal
Change in systolic blood pressure compared to placebo from baseline to study termination
Systolic blood pressure will be measured in all subjects at visits 1 through 5 or at early termination. BP will be taken using a standardized automated cuff-based instrument (Omron HEM-907XL or equivalent). Qualified site personnel will program the machine to capture a series of 3 measurements of SBP starting with a 5-minute delay for the first reading followed by a delay of 2 minutes between the subsequent readings.
Time frame: From baseline to study completion, approximately 12 weeks
Change in diastolic blood pressure compared to placebo from baseline to study termination
Diastolic blood pressure will be measured in all subjects at visits 1 through 5 or at early termination. Blood pressure will be taken using a standardized automated cuff-based instrument (Omron HEM-907XL or equivalent). Qualified site personnel will program the machine to capture a series of 3 measurements of DBP starting with a 5-minute delay for the first reading followed by a delay of 2 minutes between the subsequent readings.
Time frame: From baseline to study completion, approximately 12 weeks
Change in body weight, from baseline to study termination
BW measurements will be done without shoes or street clothing; subjects will be weighed in undergarments with gowns (front and back).
Time frame: From baseline to study completion, approximately 12 weeks
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