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The purpose of this research study is to test the safety of losartan potassium and see what effects (good and bad) it has on you and your eosinophilic esophagitis.
Losartan is a drug that is approved by the United States Food and Drug Administration (FDA) for use in adults and children over 6 years of age who have high blood pressure. Losartan has been safe when administered to patients with normal blood pressure. This medication has not been studied in people with eosinophilic esophagitis or connective tissue disorder. Eosinophils are a type of white blood cell that induces inflammation. Eosinophils with other inflammatory cells produce a protein called TGF-β, which may contribute to part of EoE. Losartan may reduce the amount of this protein and therefore, be a treatment for eosinophilic esophagitis.
You will be in the research study for approximately 4 months. Participation in this research study will involve 9 study visits. Of the 9 study visits, at least 3 visits will take place in the clinic; the other visits may take place over the telephone.
Throughout the study, the following activities will occur:
This is an open-label trial, which means that if you choose to enroll and you meet screening criteria, you will receive Losartan as a treatment. You will start the study drug at a low dose. It will be increased at vist 3 the 1 month visit. The dose of study drug will be increased depending on your weight and how well you tolerate each dose but will not exceed 100mg of study drug per day. It may be increased or decreased during the study if there are any side effects. If you do not have certain side effects, you will take each dose of the study drug between 21 and 28 days until your next study visit. You will swallow a pill or liquid once or twice a day.
This study will consist of 4 phases: screening, treatment (titration and maintenance), end of treatment, and follow-up. Participants that are between 5 to 18 years of age, as well as the parent or legal guardian will be asked to complete questionnaires of quality-of-life symptom severity questionnaires. Participants between the age of 19 and 21 will also have to fill out these questionnaires, but parents/guardians will not have to fill these out. If you are the parent or caretaker, the only study activity in which you will be involved is the completion of questionnaires about you and your family.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Losartan | Experimental | Participants with eosinophilic esophagitis receive Losartan daily |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Losartan Potassium | Drug | The dose of study drug is dependent on body weight and tolerance but did not exceed 100 mg. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percent of Participants in Histologic Remission at 16 Weeks | Percent of participants with peak eosinophil count < 15 eosinophils/high power field (remission) in distal and proximal esophagus | 16 weeks after treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Peak Eosinophil Count at 16 Weeks | Mean change in peak eosinophil count from baseline | Baseline, 16 weeks after treatment |
| Change in Pediatric EoE Symptom Score at 16 Weeks | The PEESS V2.0 questionnaire captures EoE-specific symptoms (dysphagia, GERD, nausea/vomiting, and pain) as reported by parents. The range for PEESS v2.0 scores is 0 to 100, with a higher score being indicative of more frequent and/or severe symptoms. Scores were obtained at baseline and 16 weeks. Change in score is defined as total score at 16 weeks minus total score at baseline. |
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Inclusion Criteria:
Confirmed diagnosis of eosinophilic esophagitis.
Have been on a high dose proton pump inhibitor for at least 8 weeks prior to a diagnostic endoscopy of eosinophilic esophagitis without histologic resolution.
Agree to maintain the same diet throughout the duration of the study.
If participant is female: meet one of the following criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| J. Pablo Abonia, M.D. | Children's Hospital Medical Center, Cincinnati | Principal Investigator |
| Marc E Rothenberg, M.D., Ph.D. | Children's Hospital Medical Center, Cincinnati | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kara Kliewer | Mason | Ohio | 45040 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Losartan | Participants with eosinophilic esophagitis receive the Losartan daily Losartan Potassium: The dose of study drug is dependent on body weight and tolerance but did not exceed 100 mg. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Losartan | Participants with eosinophilic esophagitis receive the Losartan daily Losartan Potassium: The dose of study drug is dependent on body weight and tolerance but did not exceed 100 mg. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percent of Participants in Histologic Remission at 16 Weeks | Percent of participants with peak eosinophil count < 15 eosinophils/high power field (remission) in distal and proximal esophagus | Posted | Number | percentage of participants | 16 weeks after treatment |
|
|
From consent to cessation of study which is approximately 24 weeks
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Losartan | Participants with eosinophilic esophagitis receive Losartan daily Losartan Potassium: The dose of study drug is dependent on body weight and tolerance but did not exceed 100 mg. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal Pain | Gastrointestinal disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Pablo Abonia, MD | Cincinnati Children's Hospital Medical Center | 513-636- | pablo.abonia@cchmc.org |
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| ID | Term |
|---|---|
| D057765 | Eosinophilic Esophagitis |
| D003240 | Connective Tissue Diseases |
| ID | Term |
|---|---|
| D004941 | Esophagitis |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| D019808 | Losartan |
| D057911 | Angiotensin Receptor Antagonists |
| ID | Term |
|---|---|
| D001713 | Biphenyl Compounds |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
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This study is an open-label study which means that all participants receive the study medicine
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| Baseline, 16 weeks after treatment |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Peak Eosinophil Count | One subjects biopsies were not evaluated by research pathologist | Mean | Standard Deviation | eosinophils per high power field |
|
| Pediatric EoE Symptom Score | Pediatric EoE Symptom score measures the frequency and severity of symptoms including nausea/vomiting, dysphagia, pain, and reflux. Scores range from 0 to 100. Higher scores indicate more frequent and/or severe symptoms. | Questionnaire not answered by one subject | Mean | Standard Deviation | units on a scale |
|
|
| Secondary | Change in Peak Eosinophil Count at 16 Weeks | Mean change in peak eosinophil count from baseline | Posted | Mean | Standard Deviation | eosinophils/high power field | Baseline, 16 weeks after treatment |
|
|
|
| Secondary | Change in Pediatric EoE Symptom Score at 16 Weeks | The PEESS V2.0 questionnaire captures EoE-specific symptoms (dysphagia, GERD, nausea/vomiting, and pain) as reported by parents. The range for PEESS v2.0 scores is 0 to 100, with a higher score being indicative of more frequent and/or severe symptoms. Scores were obtained at baseline and 16 weeks. Change in score is defined as total score at 16 weeks minus total score at baseline. | Posted | Mean | Standard Deviation | score on a scale | Baseline, 16 weeks after treatment |
|
|
|
| 0 |
| 6 |
| 0 |
| 6 |
| 2 |
| 6 |
| Back Pain | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
|
| Food impaction | Gastrointestinal disorders | Non-systematic Assessment |
|
| Headache | Nervous system disorders | Non-systematic Assessment |
|
| Heartburn | Gastrointestinal disorders | Non-systematic Assessment |
|
| Hearing loss | Ear and labyrinth disorders | Non-systematic Assessment |
|
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| D005759 |
| Gastroenteritis |
| D004802 | Eosinophilia |
| D007960 | Leukocyte Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D006838 |
| Hydrocarbons |
| D009930 | Organic Chemicals |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D013777 | Tetrazoles |
| D045504 | Molecular Mechanisms of Pharmacological Action |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |