Title

Study to Evaluate the Effect of Celecoxib on the Efficacy and Safety of Amlodipine in Subjects With Hypertension Requiring Antihypertensive Therapy
A Prospective Randomized Placebo Controlled Study to Evaluate the Effect of Celecoxib on the Efficacy and Safety of Amlodipine in Subjects With Hypertension Requiring Antihypertensive Therapy
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    amlodipine celecoxib ...
  • Study Participants

    152
The purpose of this study was to evaluate the effect of celecoxib on the efficacy and safety of amlodipine besylate in subjects with newly diagnosed hypertension requiring antihypertensive therapy.

This study was conducted to support a future marketing application for KIT-302. Kitov Pharma Ltd. (Kitov) is developing KIT-302, an oral fixed combination drug product (FCDP) consisting of the calcium channel blocker amlodipine besylate and the nonsteroidal anti-inflammatory drug (NSAID) celecoxib, as a "convenience reformulation" FCDP to facilitate and improve patient compliance with the once a day (qd) administration of its individual components, amlodipine and celecoxib.

The formulation of KIT-302 consists of amlodipine besylate and celecoxib co-formulated in a single immediate release tablet. However, for this study, two separate capsules were utilized: one containing a commercial celecoxib capsule (Celebrex®) or matched placebo capsule and one containing a commercial amlodipine besylate tablet (Norvasc®) or matched placebo tablet.

The study hypothesis was that treatment with the amlodipine besylate containing capsule plus the celecoxib containing capsule would reduce blood pressure (BP) in subjects with hypertension with an efficacy that is not substantially inferior to the effect of amlodipine besylate alone (i.e., the amlodipine containing capsule plus the matched placebo for the celecoxib capsule).

The United States (US) Food and Drug Administration (FDA) recently approved KIT-302, under the brand name Consensi® (amlodipine and celecoxib) tablets [New Drug Application (NDA) 210045] for the following indication: "patients for whom treatment with amlodipine for hypertension and celecoxib for osteoarthritis are appropriate. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions."
Study Started
Jun 26
2014
Primary Completion
Nov 19
2015
Study Completion
Nov 19
2015
Results Posted
Oct 03
2017
Last Update
Oct 10
2018

Drug Over-encapsulated 10 mg amlodipine besylate tablet

Over-encapsulated 10 mg amlodipine besylate tablet once a day for two weeks

  • Other names: Norvasc

Drug Matched placebo capsule for over-encapsulated celecoxib capsule

Matched placebo capsule for over-encapsulated celecoxib capsule once a day for two weeks

  • Other names: Placebo

Drug Over-encapsulated 200 mg celecoxib capsule

Over-encapsulated 200 mg celecoxib capsule once a day for two weeks

  • Other names: Celebrex

Drug Matched placebo capsule for over-encapsulated amlodipine besylate tablet

Matched placebo capsule for over-encapsulated amlodipine besylate tablet once a day for two weeks

  • Other names: Placebo

Amlodipine+Celecoxib Experimental

Over-encapsulated 10 mg amlodipine besylate tablet + over-encapsulated 200 mg celecoxib capsule once a day for two weeks

Amlodipine+Placebo Active Comparator

Over-encapsulated 10 mg amlodipine besylate tablet + matched placebo capsule for over-encapsulated celecoxib capsule once a day for two weeks

Placebo+Celecoxib Placebo Comparator

Matched placebo capsule for over-encapsulated amlodipine besylate tablet + over-encapsulated 200 mg celecoxib capsule once a day for two weeks

Placebo+Placebo Sham Comparator

Matched placebo capsule for over-encapsulated amlodipine besylate tablet + matched placebo capsule for over-encapsulated celecoxib capsule once a day for two weeks

Criteria

Inclusion Criteria:

Adult 40 to 75 years of age

Newly diagnosed hypertension that requires chronic pharmacological therapy. Specifically, the subject must meet both of the following criteria:

Resting systolic BP ≥140 mmHg and ≤179 mmHg (where resting is defined as supine for at least 10 minutes with minimal interaction) at Initial Screening Visit
SBPday >135 mmHg at Baseline Visit (Day 0)
Body Mass Index of 18.5 to 34.9 kg/m2
Healthy (other than hypertension) as determined by the Investigator based on medical history, physical examination, vital signs, 12-lead electrocardiogram (ECG), and clinical laboratory tests
A negative pregnancy test at Screening
Both males and women of child bearing potential agree to use adequate contraceptive methods while on study (from Screening through final study visit)
Able to comprehend and sign an informed consent form

Exclusion Criteria:

Resting systolic BP >179 mmHg or a resting diastolic BP >110 mmHg at Screening (where resting is defined as supine for at least 10 minutes with minimal interaction) or SBP24h >169 mmHg or DBP24h >110 mmHg at randomization
SBPday ≤135 mmHg at baseline (Day 0)
Weight <55 kg
Fragile health
Evidence of clinically significant findings on screening evaluations (clinical, laboratory, and ECG) which, in the opinion of the Investigator would pose a safety risk or interfere with appropriate interpretation of safety data
Current or recent history (within 4 weeks prior to Screening) of a clinically significant bacterial, fungal, or mycobacterial infection
Current clinically significant viral infection
History of malignancy, with the exception of cured basal cell or squamous cell carcinoma of the skin
Major surgery within 4 weeks prior to Screening
Presence of a malabsorption syndrome possibly affecting drug absorption (e.g., Crohn's disease or chronic pancreatitis)
Active peptic ulceration or history of gastrointestinal bleeding
History of myocardial infarction, congestive heart failure, or stroke
Any current cardiovascular disease
History of psychotic disorder
History of alcoholism or drug addiction or current alcohol or drug use that, in the opinion of the Investigator, will interfere with the subject's ability to comply with the dosing schedule and study evaluations
History of any illicit drug use within one year prior to Screening
Positive drug screen at Screening. A positive drug screen for opiates only (with all other drug tests negative) will not be a basis for exclusion if the subject took over-the-counter narcotics as indicated on the product label within 24 hours prior to the drug screen
Current treatment or treatment within 30 days prior to first dose of study drugs with another investigational drug or current enrollment in another clinical trial
Current treatment or treatment within 30 days prior to first dose of study drugs with an NSAID or systemic corticosteroid
Known history of human immunodeficiency virus, hepatitis B, or hepatitis C
Known hypersensitivity to amlodipine or celecoxib
Known hypersensitivity to the inactive ingredients in the over-encapsulated study drugs
Asthma, acute rhinitis, nasal polyps, angioneurotic oedema, urticaria or other allergic type reactions after taking acetylsalicylic acid or NSAIDs including cyclooxygenase-2 inhibitors
Subjects who, in the opinion of the Investigator, are unable or unlikely to comply with the dosing schedule and study evaluations
Pregnant or lactating
Unable to correctly use ambulatory blood pressure monitor after instruction on its use
Subjects with Child-Pugh Class B or C cirrhosis;
Subjects currently taking a calcium channel blocker for any reason including angina. Subjects will not be withdrawn from these drugs to be enrolled in the trial
Creatinine clearance <50 ml/min as estimated by the Cockroft-Gault equation
Known cytochrome P450 2C9 poor metabolizer
Subjects with allergy or hypersensitivity to sulfonamides

Summary

Amlodipine+Celecoxib

Amlodipine+Placebo

Placebo+Celecoxib

Placebo+Placebo

All Events

Event Type Organ System Event Term Amlodipine+Celecoxib Amlodipine+Placebo Placebo+Celecoxib Placebo+Placebo

Mean Change in Average Daytime (9:00 to 21:00) Ambulatory Systolic Blood Pressure (SBPday) - Primary Endpoint

Amlodipine+Celecoxib

-10.6
mmHg (Mean)
Standard Deviation: 9.2

Amlodipine+Placebo

-8.83
mmHg (Mean)
Standard Deviation: 8.13

Placebo+Celecoxib

-0.5
mmHg (Mean)
Standard Deviation: 8.8

Placebo+Placebo

-2.11
mmHg (Mean)
Standard Deviation: 8.2

Frequency of Adverse Events (Number of Participants Affected/Number of Participants at Risk)

Including any untoward medical occurrence in a participant administered study drug, which do not necessarily have a causal relationship with the study drug [i.e., any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not related to the study drug].

Amlodipine+Celecoxib

Amlodipine+Placebo

Placebo+Celecoxib

Placebo+Placebo

Mean Change in Average 24-hour Ambulatory Systolic Blood Pressure (SBP24h)

Amlodipine+Celecoxib

-10.3
mmHg (Mean)
Standard Deviation: 8.9

Amlodipine+Placebo

-8.02
mmHg (Mean)
Standard Deviation: 7.6

Placebo+Celecoxib

-0.5
mmHg (Mean)
Standard Deviation: 7.8

Placebo+Placebo

-1.19
mmHg (Mean)
Standard Deviation: 5.87

Mean Change in Average Night-time (01:00 to 06:00) Ambulatory Systolic Blood Pressure (SBPnight)

Amlodipine+Celecoxib

-10.5
mmHg (Mean)
Standard Deviation: 10.6

Amlodipine+Placebo

-6.35
mmHg (Mean)
Standard Deviation: 11.35

Placebo+Celecoxib

-1.7
mmHg (Mean)
Standard Deviation: 12.3

Placebo+Placebo

-1.42
mmHg (Mean)
Standard Deviation: 9.15

Mean Change in Average 24-hour Ambulatory Diastolic Blood Pressure (DBP24h)

Amlodipine+Celecoxib

-7.1
mmHg (Mean)
Standard Deviation: 5.6

Amlodipine+Placebo

-4.8
mmHg (Mean)
Standard Deviation: 4.83

Placebo+Celecoxib

-0.5
mmHg (Mean)
Standard Deviation: 4.6

Placebo+Placebo

0.22
mmHg (Mean)
Standard Deviation: 4.28

Mean Change in Average Daytime (9:00 to 21:00) Ambulatory Diastolic Blood Pressure (DBPday)

Amlodipine+Celecoxib

-7.5
mmHg (Mean)
Standard Deviation: 6.4

Amlodipine+Placebo

-5.53
mmHg (Mean)
Standard Deviation: 5.06

Placebo+Celecoxib

-1.5
mmHg (Mean)
Standard Deviation: 5.6

Placebo+Placebo

-0.32
mmHg (Mean)
Standard Deviation: 5.39

Mean Change in Average Night-time (01:00 to 06:00) Ambulatory Diastolic Blood Pressure (DBPnight)

Amlodipine+Celecoxib

-7.0
mmHg (Mean)
Standard Deviation: 8.6

Amlodipine+Placebo

-3.23
mmHg (Mean)
Standard Deviation: 7.79

Placebo+Celecoxib

0.3
mmHg (Mean)
Standard Deviation: 7.1

Placebo+Placebo

0.01
mmHg (Mean)
Standard Deviation: 6.23

Mean Non-transformed Amlodipine Plasma Concentration

Amlodipine+Celecoxib

Amlodipine+Placebo

Mean Non-transformed Celecoxib Plasma Concentration

Amlodipine+Celecoxib

139.708
ng/mL (Mean)
Standard Deviation: 86.504

Placebo+Celecoxib

138.667
ng/mL (Mean)
Standard Deviation: 118.811

Mean Log-transformed Amlodipine Plasma Concentration

Amlodipine+Celecoxib

9.634
log(pg/mL) (Mean)
Standard Deviation: 0.268

Amlodipine+Placebo

10.025
log(pg/mL) (Mean)
Standard Deviation: 0.310

Mean Log-transformed Celecoxib Plasma Concentration

Amlodipine+Celecoxib

4.785
log(ng/mL) (Mean)
Standard Deviation: 0.564

Placebo+Celecoxib

4.636
log(ng/mL) (Mean)
Standard Deviation: 0.781

Mean Change in Average Daytime (9:00 to 21:00) Ambulatory Systolic Blood Pressure (SBPday) - Secondary Endpoint

Amlodipine+Placebo

-8.83
mmHg (Mean)
Standard Deviation: 8.13

Placebo+Celecoxib

-0.5
mmHg (Mean)
Standard Deviation: 8.8

Placebo+Placebo

-2.11
mmHg (Mean)
Standard Deviation: 8.2

Amlodipine+Celecoxib

-10.6
mmHg (Mean)
Standard Deviation: 9.2

Total

152
Participants

Age, Continuous

56.1
years (Mean)
Standard Deviation: 8.8

Average Daytime (9:00 to 21:00) Ambulatory Systolic Blood Pressure (SBPday)

148.5
mmHg (Mean)
Standard Deviation: 8.4

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

Amlodipine+Celecoxib

Amlodipine+Placebo

Placebo+Celecoxib

Placebo+Placebo

Drop/Withdrawal Reasons

Amlodipine+Placebo

Placebo+Celecoxib

Placebo+Placebo