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Isosorbide mononitrate

Phase 1

Hypertension | Small molecule | Cardiovascular |Merck & Company, Inc.|Last Updated: Jul 28, 2015

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindCONTROLLED
Total Trials1
Total Enrollment64
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT00871871Multiple Dose Effects of Hydrochlorothiazide and Isosorbide Mononitrate on Glucose Homeostasis (MK-0000-117)(Completed)PHASE1 COMPLETED 64Mar 1, 2009Mar 1, 2010Jul 28, 2015 -
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Study Endpoints
Primary Endpoints
Part I: Change in Insulin Secretion at Steady-state Compared to Placebo in Participants With Impaired Glucose Tolerance (IGT)
90 -120 minutes post-dose

Steady state was defined as 90-120 minutes post-dose. IGT was defined as a 2 hour plasma glucose \>= 140 and \<= 199 mg/dL during a 75g oral glucose tolerance test at screening.

Part I: Change in Insulin Secretion at Steady-state Compared to Placebo in Participants With Impaired Fasting Glucose (IFG)
90 -120 minutes post-dose

Steady state was defined as 90-120 minutes post-dose. IFG was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dL at screening.

Part I: Change in Insulin Secretion at Steady-state Compared to Placebo in Participants Who Had Normal Glucose Tolerance (NGT)
90 -120 minutes post-dose

Steady state was defined as 90-120 minutes post-dose. NGT participants (FPG \<100 mg/dL \& 2 hour plasma glucose (PG) \<140 mg/dL during a 75g oral glucose tolerance test (OGTT) at screening) were neither Impaired Glucose Tolerant (IGT) nor Impaired Fasting Glucose (IFG). IGT was defined as a 2 hour plasma glucose \>= 140 and \<= 199 mg/dL during a 75g oral glucose tolerance test at screening. IFG was defined as FPG between 100 and 125 mg/dL at screening.

Part II: Ratio of Whole Body Glucose Disposal to Plasma Insulin at Steady-state
90 -120 minutes post-dose

Steady state was defined as 90-120 minutes post-dose. The ratio was the quantity of glucose disposed by the body per kg body weight per minute at steady state divided by the approximate steady state plasma insulin concentration. The approximate steady state plasma insulin concentration was estimated by the time-weighted average of the insulin concentration measured at 10 minute intervals in which time = 90, 100, 110, and 120 minutes.

Secondary Endpoints
Part I: Change in the Ratio of Whole Body Glucose Disposal to Plasma Insulin at Steady State in Participants With Impaired Glucose Tolerant (IGT)
90 -120 minutes post-dose
Part I: Change in the Ratio of Whole Body Glucose Disposal to Plasma Insulin at Steady State in Participants With Impaired Fasting Glucose (IFG)
90 -120 minutes post-dose
Part I: Change in the Ratio of Whole Body Glucose Disposal to Plasma Insulin at Steady State in Participants With Normal Glucose Tolerant (NGT)
90 -120 minutes post-dose
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Study Design & Arms
AllocationRANDOMIZED
MaskingDOUBLE
ModelCROSSOVER
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Part I, Placebo-HCTZEXPERIMENTALPlacebo in Period 1 followed by HCTZ in Period 2
Part I, HCTZ-PlaceboEXPERIMENTALHCTZ in Period 1, followed by placebo in Period 2
Part II, Placebo-ISMNEXPERIMENTALPlacebo in Period 1, followed by ISMN in Period 2
Part II, ISMN-PlaceboEXPERIMENTALISMN in Period 1, followed by placebo in Period 2
Interventions
NameTypeDescription
Hydrochlorothiazide (HCTZ)DRUGHCTZ 50 mg (two 25 mg capsules) once daily for 4 weeks per treatment period.
Comparator: Placebo to HCTZDRUGPlacebo to HCTZ two 0 mg capsules once daily for 4 weeks per treatment period
Isosorbide mononitrate (ISMN)DRUGISMN 60 mg extended release capsule once daily for 4 weeks per treatment period
Comparator: Placebo to ISMNDRUGPlacebo to ISMN 0 mg capsule once daily for 4 weeks per treatment period
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Eligibility Criteria
Age Range35 Years — 75 Years
SexALL
Healthy VolunteersNo

Inclusion Criteria: * Female participants must be post-menopausal * Body Mass Index (BMI) of at least 29 kg/m\^2 * Weight has been stable over the past 3 months * Has never been treated for hypertension or is diagnosed with hypertension taking up to 2 anti-hypertensive medications * Willing to stop...

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