Clevidipine in the Treatment of Patients With Severe Hypertension (VELOCITY)

Study Overview
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Brief Summary
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The purpose of this study was to determine the safety of clevidipine for treating severely elevated blood pressure, defined as systolic (SBP) >180 mmHg and/or diastolic blood pressure (DBP) >115 mmHg assessed on 2 successive occasions 15 minutes apart at baseline, in patients with or without major organ injury, particularly with respect to controlled dose adjustment to desired effect and prolonged continuous infusion. Enrollment of patients into the study was to continue until the target goal of 100 patients with at least 18 hours of continuous clevidipine treatment, including a minimum of 50 patients with acute or chronic end-organ injury, was met.

Official Title
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Evaluation of the Effect of Ultrashort-Acting Clevidipine in the Treatment of Patients With Severe Hypertension (VELOCITY)

Conditions
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Hypertension

Intervention / Treatment
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* Drug: clevidipine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18 years or older Systolic blood pressure >180 mmHg and/or diastolic blood pressure >115 mmHg assessed on two successive occasions, 15 minutes apart at baseline Written informed consent Exclusion Criteria: SBP ≤180 mmHg and/or DBP ≤115 mmHg Expectation that the patient will not tolerate intravenous antihypertensive therapy for at least 18 hours Known or suspected aortic dissection Administration of an agent for treating hypertension within 2 hours of clevidipine administration Severe hypertension known to be precipitated by use of, or withdrawal from, alcohol or illicit drugs, or intentional overdose of illicit or prescription drugs Positive pregnancy test Intolerance to calcium channel blockers Allergy to soybean oil or egg lecithin Known liver failure or cirrhosis Participation in clinical research studies of other investigational drugs or devices within 30 days of enrollment

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: clevidipine<br>A patient-specific blood pressure target range (TR) of ≥20 mm Hg and ≤40 mm Hg SBP was prespecified by the investigator. Once established, clevidipine (0.5 mg/mL in 20% lipid emulsion) intravenous infusion was initiated at 2.0 mg/h and maintained for the first 3 minutes. Clevidipine was up-titrated, as tolerated by the patient, by doubling the dose every 3 minutes until the prespecified systolic blood pressure (SBP) target range was achieved and could continue to be titrated up or down to maintain the desired long-term SBP reduction. | Drug: clevidipine<br>* Clevidipine was required to be administered continuously for a minimum of 18 hours and a maximum of 96 hours and was not to exceed a rate of 32.0 mg/h at any time. Use of an additional or alternative intravenous antihypertensive agent was allowed if the blood pressure target range was not achieved or maintained. If transition to an oral antihypertensive agent is required, then approximately 1 hour prior to the anticipated cessation of clevidipine infusion, but no less than at the 18-hour time point, an oral antihypertensive agent was allowed to be administered as clevidipine was down-titrated or terminated as needed in order to achieve the desired blood pressure level..<br>* Other names: clevidipine, Cleviprex;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of patients in whom SBP falls below the lower limit of the patient-specific, pre-determined blood pressure target range at the initial dose (2.0 mg/h) |  | Study drug initiation through the first 3 minutes of the infusion | 
| Percentage of patients who reach the prespecified target SBP range |  | Within 30 minutes of the initiation of the infusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to attainment of the 30-minute SBP target range |  | During the 30-minute period from initiation of infusion | 
| Change in heart rate |  | During the 30-minute period from initiation of infusion | 
| Mean and median dose of clevidipine during the treatment period |  | Treatment period is from initiation of infusion until study drug termination (minimum of 18 hours up to a maximum of 96 hours) | 
| Proportion of patients transitioning to oral antihypertensive therapy |  | Within 6 hours of stopping study drug infusion | 
| Safety of clevidipine infusion for 18 hours or longer |  | Treatment period is from initiation of infusion until study drug termination (minimum of 18 hours up to a maximum of 96 hours) |