Evaluation of efficacy and tolerance of fludrocortisone (Flucortac) in the treatment of neurogenic orthostatic hypotension

2024-517841-16-00 Protocol HAC2018-001 Therapeutic use (Phase IV) Ongoing, recruiting

Start 9 Jul 2020 · Status Ongoing, recruiting · 1 EU/EEA countries · 10 sites · Protocol HAC2018-001

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Ongoing, recruiting
Participants planned 90
Countries 1
Sites 10

Neurogenic Orthostatic Hypotension

To evaluate the efficacy of a 4-week treatment with fludrocortisone (FLU) at stable dose on the decrease of systolic and diastolic blood pressure after 5 minutes of active orthostatism, in patients with neurogenic orthostatic hypotension

Key facts

Sponsor
H.A.C. Pharma
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Nervous System Diseases [C10]
Trial duration
9 Jul 2020 → ongoing
Decision date (initial)
2024-10-29
Transition trial
Yes
Low-intervention
No
Rare-disease indication
No
Vulnerable population
Yes

External identifiers

EU CT number
2024-517841-16-00
EudraCT number
2018-003905-25
ClinicalTrials.gov
NCT04128137

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Safety, Efficacy

To evaluate the efficacy of a 4-week treatment with fludrocortisone (FLU) at stable dose on the decrease of systolic and diastolic blood pressure after 5 minutes of active orthostatism, in patients with neurogenic orthostatic hypotension

Secondary objectives 8

  1. To evaluate the efficient dose of FLU to control NOH
  2. To evaluate the effect of FLU on systolic blood pressure in supine and stand-up positions
  3. To evaluate the effect of a treatment with FLU on prevalance and severity of the symptoms related to NOH
  4. To evaluate the full responders rate (no symptoms and BP decrease <20 and/or 10 mmHg for systolic and diastolic values respectively) or partial responders rate (no symptoms but persistance of BP decrease) during treatment with FLU
  5. To evaluate the effect of the treatment on nocturnal decubitus BP
  6. To evaluate the effect of the treatment on left ventricular mass and ejection fraction on cardiac ultrasound
  7. To evaluate the safety (adverse events) of FLU in the studied indication
  8. To evaluate the effect of the treatment on the quality of life

Conditions and MedDRA coding

Neurogenic Orthostatic Hypotension

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 4

  1. Age >18 years
  2. Orthostatic hypotension (blodo pressure decrease >20 and/or 10mmHg on systolic and diastolic values within 3 minutes after standup, and symptomatic according to the Orthostatic Hypotension Questionnaire OHQ: score different than 0 in at least 1 of the 6 items
  3. Patients suffering from a neurologic disease (Parkinson disease, multisystemic atrophy, Lewy bodies dementia, isolated progressive dysautonomia) or metabolic disease (diabetes, renal failure) known to be linked with an autonomous nervous system dysfunction and with NOH
  4. Persistant and symptomatic NOH despite the use of non-medicinal measures (lower limbs contention) and medicinal products (midodrine)

Exclusion criteria 7

  1. Age <18 years
  2. Hypersensitivity to FLU or to one of its excipients
  3. Medical history of documented cardiac failure
  4. Medical history of left ventricular systolic dysfunction
  5. Non-compensated hypokalaemia
  6. Nocturnal or supine hypertension
  7. Pregnant or breastfeeding patients

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Efficacy on the systolic and diastolic BP decrease when moving from supine and stand-up position

Secondary endpoints 3

  1. Evaluation of the symptoms related to NOH through the OHQ scale
  2. Evaluation of the quality of life through the SF36 scale
  3. Collection of clinical adverse events, biological and blood pressure anomalies

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

FLUCORTAC 50 microgrammes, comprimé sécable

PRD2072822 · Product

Active substance
Fludrocortisone Acetate
Pharmaceutical form
TABLET
Route of administration
ORAL
Max daily dose
200 µg microgram(s)
Max total dose
36000 µg microgram(s)
Max treatment duration
6 Month(s)
Authorisation status
Authorised
ATC code
H02AA02 — FLUDROCORTISONE
Marketing authorisation
3400939060668
MA holder
ASSISTANCE PUBLIQUE - HOPITAUX DE PARIS - AP-HP
MA country
France
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Placebo 1

Cellulose microcristalline 50 microgrammes

N/A · Product

Other product name
N/A
Pharmaceutical form
N/A
ATC code
N/A — N/A
Marketing authorisation
N/A
MA holder
N/A
MA country
Iceland
Paediatric formulation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

H.A.C. Pharma

Sponsor organisation
H.A.C. Pharma
Address
Pericentre 2, 43 Avenue De La Cote De Nacre 43 Avenue De La Cote De Nacre
City
Caen
Postcode
14000
Country
France

Scientific contact point

Organisation
H.A.C. Pharma
Contact name
CERFON

Public contact point

Organisation
H.A.C. Pharma
Contact name
CERFON

Locations

1 EU/EEA country · 10 investigational sites

By country

CountryMS statusPlanned subjectsSites
France Ongoing, recruiting 90 10
Rest of world 0

Investigational sites

France

10 sites · Ongoing, recruiting
Centre Hospitalier Universitaire De Nantes
Médecine Polyvalente Gériatrique et SSR, 41 Rue Curie, 44093, Nantes Cedex 1
Centre Hospitalier Universitaire D'Angers
Médecine Gériatrique Aigue, 4 Rue Larrey, 49100, Angers
Hospices Civils De Lyon
Neurologie, 27 Rue Gabriel Peri, 69100, Villeurbanne
Centre Hospitalier Universitaire De Nantes
Gériatrie, 85 Rue Saint Jacques, 44200, Nantes
Centre Hospitalier Universitaire De Toulouse
Neurologie, 1 Avenue Du Professeur Jean Poulhes, Tsa 50032, Toulouse Cedex 9
Centre Hospitalier Et Universitaire De Limoges
Gérontologie clinique, 2 Avenue Martin Luther King, 87042, Limoges Cedex 1
Assistance Publique Hopitaux De Paris
Gériatrie, 54 56 Rue Pascal 54a, 75013, Paris
Centre Hospitalier Universitaire De Nantes
Médecine Gériatrique Aigue, Boulevard Du Professeur Jacques Monod, 44800, Saint Herblain
Assistance Publique Hopitaux De Paris
Endocrinologie, 46 Rue Henri Huchard, 75877, Paris Cedex 18
Centre Hospitalier Universitaire De Montpellier
Unité de Médecine interne et soins aigus gériatriques, 39 Avenue Charles Flahault, Pavillon 32, Montpellier Cedex 5

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
France 2020-07-09 2024-10-29

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 5 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) 2024-517841-16-00_PROTOCOLE_FLU-HON 3
Recruitment arrangements (for publication) 2024-517841-16-00_Recruitment arrangements_FLU-HON 1
Subject information and informed consent form (for publication) 2024-517841-16-00_NICE_FLU-HON 2
Summary of Product Characteristics (SmPC) (for publication) 2024-517841-16-00_RCP Flucortac_FLU-HON 1
Synopsis of the protocol (for publication) 2024-517841-16-00_SYNOPSIS_FLU-HON 3

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-10-01 France Acceptable
2024-10-25
2024-10-29