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| Name | Class |
|---|---|
| IndiPharm Inc. | UNKNOWN |
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Cicletanine, which has been approved and launched for hypertension in France and Germany, has promise beyond hypertension in critically-unmet needs such as diabetes. It is evident from in vitro, animal and human studies that cicletanine's optimal dose in diabetes and other challenging, critically-unmet needs is likely to be higher than that for hypertension. Cicletanine's maximum tolerated dosage is not known, but the drug's dose-limiting effects are documented to be potassium loss and sodium loss from thiazide-type activity (one of the therapeutic mechanisms the drug is known to have); such thiazide-type losses are known to be reversed safely by magnesium. This trial explores the ability of magnesium to enhance cicletanine safety at higher doses in a trial involving patients with hypertension complicated by diabetes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cicletanine | Active Comparator | Patients will take escalating doses of cicletanine |
|
| Cicletanine + magnesium | Experimental | Patients will take escalating doses of cicletanine; patients will in addition take magnesium |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cicletanine + magnesium | Drug | Cicletanine is an orally-dosed furopyridine drug launched or hypertension in France in 1988 (and soon thereafter in Germany by IPSEN. While the drug's maximum tolerated dose is not known, the principal concern (and so far only material concern) at higher doses is the decrease in levels of sodium and potassium. Trials so far have take n the drug up to 400 mg QD (once daily); it was well tolerated at that dose. The drug has had an excellent safety profile in its ~1.8 million patient-years of post-launch experience, Magnesium is being added to cicletanine in order to decrease losses of potassium and sodium, thereby enhancing cicletanine's safety at higher doses. |
| Measure | Description | Time Frame |
|---|---|---|
| Time to potassium rescue | The primary endpoint is the preservation of potassium levels at or above 3.3 mEq/L (milliequivalents per liter). A time to event model using the Log Rank test will be used to compare the Mg Group and those in the Non-Mg Group. | 13 weeks (duration of study) |
| Measure | Description | Time Frame |
|---|---|---|
| Reduction in systolic blood pressure vs. baseline | Aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible. | 13 weeks (duration of study) |
| Reduction in diastolic blood pressure vs. baseline |
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Inclusion Criteria:
Sitting SBP (systolic blood pressure) > 150 mmHg (millimeters of mercury) after five minutes' rest.
Type II diabetes, with HbA1c between 8.5 and 11.5%. If a patient at screening presents outside of this range, the investigator may elect to re-screen a patient once to determine further the patient's eligibility.
Age >18 and < 80 years of age
BMI between 20 and 35, inclusive
Have been stable on existing therapy for at least 30 days prior to initiation of cicletanine (Visit 2)
a. no change in antihypertensive nor antihyperglycemia agent dose within 30 days prior to screening visit.
Willing to comply with the requirements of the protocol.
Willing to provide written Informed Consent to participate in the study approved by an appropriately constituted IRB (Institutional Review Board).
All females who are not post-menopausal should be using at least two forms of contraception during the entire study.
Exclusion Criteria:
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| D003920 | Diabetes Mellitus |
| D007008 | Hypokalemia |
| D007010 | Hyponatremia |
| D008659 | Metabolic Diseases |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D044882 | Glucose Metabolism Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| C038068 | cicletanine |
| D008274 | Magnesium |
| ID | Term |
|---|---|
| D008673 | Metals, Alkaline Earth |
| D004602 | Elements |
| D007287 | Inorganic Chemicals |
| D019565 | Metals, Light |
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|
| Cicletanine | Drug | Cicletanine is an orally-dosed furopyridine drug launched or hypertension in France in 1988 (and soon thereafter in Germany by IPSEN. While the drug's maximum tolerated dose is not known, the principal concern (and so far only material concern) at higher doses is the decrease in levels of sodium and potassium. Trials so far have take n the drug up to 400 mg QD; it was well tolerated at that dose. The drug has had an excellent safety profile in its ~1.8 million patient-years of post-launch experience, |
|
Aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible. |
| 13 weeks (duration of study) |
| Reduction in HbA1c vs. baseline | Aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible. | 13 weeks (duration of study) |
| CRP (C reactive protein) levels | CRP (C-reactive protein) is a measure of general inflammation. This will be an aggregate measure made for all 24 patients (12 cicletanine + magnesium; 12 cicletanine only). Subgroup analyses will also be made as feasible. | 13 weeks (duration of study) |
| Average levels of potassium in patients on cicletanine with and without magnesium | The average potassium levels levels in the two groups (cicletanine + magnesium; cicletanine only) will be compared. Subgroup analyses will also be made as feasible. | 13 weeks (duration of study) |
| Average levels of sodium in patients on cicletanine with and without magnesium | The average sodium levels levels in the two groups (cicletanine + magnesium; cicletanine only) will be compared. Subgroup analyses will also be made as feasible. | 13 weeks (duration of study) |
| Average levels of magnesium in patients on cicletanine with and without magnesium | The average magnesium levels levels in the two groups (cicletanine + magnesium; cicletanine only) will be compared. Subgroup analyses will also be made as feasible. | 13 weeks (duration of study) |
| D004700 | Endocrine System Diseases |
| D014883 | Water-Electrolyte Imbalance |
| D008670 |
| Metals |