One-Year Safety and Tolerability Study of Azilsartan Medoxomil in Participants With Essential Hypertension

Study Overview
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Brief Summary
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This purpose of this study is to evaluate the long-term safety and tolerability of azilsartan medoxomil in individuals with essential hypertension.

Detailed Description
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Hypertension affects approximately 50 million individuals in the United States. As the population ages, the prevalence of hypertension will continue to increase if broad and effective preventive measures are not implemented. According to the World Health Organization, hypertension is the most common attributable cause of preventable death in developed nations, as uncontrolled hypertension greatly increases the risk of cardiovascular disease, cerebrovascular disease, and renal failure. Despite the availability of antihypertensive treatments, hypertension remains inadequately controlled; only about one-third of patients continue to maintain control successfully. Takeda Global Research and Development is developing TAK-491 (azilsartan medoxomil) for the treatment of essential hypertension. This study is being conducted to demonstrate the long-term safety and tolerability of azilsartan medoxomil in individuals with essential hypertension. Study participation is anticipated to be approximately 1 year and 1.5 months, and participants will be required to return to the clinic for 10 study visits.

Official Title
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A One-Year Phase 3, Open-Label Study to Evaluate the Safety and Tolerability of TAK-491 in Subjects With Essential Hypertension

Conditions
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Hypertension

Intervention / Treatment
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* Drug: Azilsartan medoxomil with or without add-on chlorthalidone
* Drug: Azilsartan medoxomil with or without add-on hydrochlorothiazide


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria Diastolic blood pressure greater than or equal to 95 mm Hg and less than or equal to 119 mm Hg. For diabetic subjects and subjects with chronic kidney disease, diastolic blood pressure must be greater than or equal to 85 mm Hg and less than or equal to109 mm Hg). Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating. Clinical laboratory evaluations within the reference range for or deemed not clinically significant by the investigator. Exclusion Criteria Systolic blood pressure greater than 185 mm Hg. Expected to take angiotensin II receptor blockers other than the study drug. Taking more than 2 antihypertensive agents. Hypersensitive to angiotensin II receptor blockers, thiazide-type diuretics or sulfonamide-derived compounds. Recent history of major cardiovascular event. History of moderate to severe heart failure or hypertensive encephalopathy. Clinically significant cardiac conduction defects. Secondary hypertension of any etiology. Known or suspected unilateral or bilateral renal artery stenosis. Severe renal dysfunction or disease. History of drug abuse or a history of alcohol abuse within the past 2 years. Previous history of cancer that has not been in remission for at least 5 years prior to the first dose of study drug.. Uncontrolled diabetes mellitus. Alanine aminotransferase level of greater than 2.5 times the upper limit of normal, active liver disease, or jaundice. Serum potassium level of greater than the upper limit of normal. Currently is participating in another investigational study or has participated in an investigational study within 30 days prior to enrollment. Any other serious disease or condition. Randomized in a previous azilsartan medoxomil study.

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
Allocation: Non-Randomized
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Azilsartan Medoxomil<br> | Drug: Azilsartan medoxomil with or without add-on chlorthalidone<br>* Azilsartan medoxomil 40 mg, tablets, orally, once daily for four weeks; increased to azilsartan medoxomil 80 mg, tablets, orally, once daily for remainder of 56-week treatment period, if tolerated. Additional antihypertensive medications added, beginning with chlorthalidone 25 mg, once-daily, if target blood pressure not achieved.<br>* Other names: Edarbi;Drug: Azilsartan medoxomil with or without add-on hydrochlorothiazide<br>* Azilsartan medoxomil 40 mg, tablets, orally, once daily for four weeks; increased to azilsartan medoxomil 80 mg, tablets, orally, once daily for remainder of 56-week treatment period, if tolerated. Additional antihypertensive medications added, beginning with hydrochlorothiazide 12.5 to 25 mg, once-daily, if target blood pressure not achieved.<br>* Other names: Edarbi;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Reporting One or More Treatment-emergent Adverse Events From Day 1 Through End of the Study - Cohort 1. | Treatment-emergent adverse events are defined as any unfavorable and unintended sign, symptom or disease temporally associated with the use of a medicinal product reported from first dose of study drug through 14 days after the last dose of study drug, or if a serious adverse event, within 30 days after the last dose of study drug. | 56 weeks. | 
| Number of Participants Reporting One or More Treatment-emergent Adverse Events From Day 1 Through End of the Study - Cohort 2. | Treatment-emergent adverse events are defined as any unfavorable and unintended sign, symptom or disease temporally associated with the use of a medicinal product reported from first dose of study drug through 14 days after the last dose of study drug, or if a serious adverse event, within 30 days after the last dose of study drug. | 56 weeks. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change From Baseline in Sitting Clinic Systolic Blood Pressure - Cohort 1. | The change between sitting clinic systolic blood pressure measured at each week assessed relative to the baseline measurement. Mean calculated by using the average (arithmetic mean) of 3 measurements performed at each visit. | 52 weeks | 
| Change From Baseline in Sitting Clinic Systolic Blood Pressure - Cohort 2 | The change between sitting clinic systolic blood pressure measured at each week assessed relative to the baseline measurement. Mean calculated by using the average (arithmetic mean) of 3 measurements performed at each visit. | 52 weeks | 
| Change From Baseline in Sitting Clinic Diastolic Blood Pressure - Cohort 1. | The change between sitting clinic diastolic blood pressure measured at each week assessed relative to the baseline measurement. Mean calculated by using the average (arithmetic mean) of 3 measurements performed at each visit. | 52 weeks. | 
| Change From Baseline in Sitting Clinic Diastolic Blood Pressure - Cohort 2. | The change between sitting clinic diastolic blood pressure measured at each week assessed relative to the baseline measurement. Mean calculated by using the average (arithmetic mean) of 3 measurements performed at each visit. | 52 weeks. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Essential Hypertension, Cardiovascular Disease, High Blood Pressure, Drug Therapy