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Aliskiren/Amlodipine and Aliskiren/Amlodipine/HCTZ

Phase 3

Essential Hypertension | Small molecule | Cardiovascular |Novartis AG|Last Updated: Jun 7, 2021

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-BlindPLACEBO_CONTROLLEDBiomarker
Total Trials4
Total Enrollment2,907
FDA Designations
No designations recorded
Clinical Trials (4)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT01237223Efficacy and Safety of SPA100 (Fixed-dose Combination of Aliskiren/Amlodipine) in Patients With Essential HypertensionPHASE3 COMPLETED 1,342Oct 1, 2010May 1, 2011Jun 13, 201211 Japan
NCT01113047Aliskiren in Combination With Amlodipine in Hypertensive Patients Not Responding to Angiotensin Receptor Blocker (ARB) Plus AmlodipinePHASE3 COMPLETED 347May 1, 2010 -Dec 6, 20131 Germany
NCT00667719A Long Term Safety Study to Test the Combination of Aliskiren/ Amlodipine / Hydrochlorothiazide in Participants With Essential HypertensionPHASE3 COMPLETED 564Jun 5, 2008Oct 5, 2009Jun 7, 20218 United States, Belgium +6
NCT00343551Efficacy and Safety of Aliskiren 300mg Compared to Irbesartan 300mg and Ramipril 10 mg in the Setting of a Missed Dose for Patients With Essential Hypertension.PHASE3 COMPLETED 654May 1, 2006 -Feb 23, 20172 Germany, Switzerland
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Study Endpoints
Primary Endpoints
Change From Baseline in Mean Sitting Diastolic Blood Pressure (msDBP) to End of Study (Week 8)
Baseline, Week 8

Sitting blood pressure was measured at trough (24 hours ± 2 hours post dose) and recorded at all study visits. At the first study visit, blood pressure was measured in both arms and the arm with highest sitting DBP was found and used for all subsequent readings throughout the study. The repeat sitting measurements were made at 1-2 minute intervals and the mean of these three sitting blood pressure measurements were used as the average sitting blood pressure for that visit. Analysis of covariance (ANCOVA) model contained treatment and region as two factors and baseline as a covariate.

Change in mean sitting diastolic blood pressure after 4 weeks of treatment
4 weeks
Number of Participants With Any Adverse Events (AEs), Serious Adverse Events (SAEs) and Death
54 weeks

An AE was defined as the appearance or worsening of any undesirable sign, symptom, or medical condition occurring after starting the study drug, even if the event is not considered to be related to study drug. An SAE was defined as an event which was fatal or life-threatening, resulted in persistent or significant disability/incapacity, constituted a congenital anomaly/birth defect, required inpatient hospitalization or prolongation of existing hospitalization, was medically significant, i.e. defined as an event that jeopardizes the participant or may require medical or surgical intervention to prevent one of the outcomes listed above.

Mean 24-hour ambulatory diastolic blood pressure (MADBP) change from baseline, after a missed dose, aliskiren 300 mg versus irbesartan 300mg.
from baseline.
Mean 24-hour ambulatory diastolic blood pressure (MADBP) change from baseline, after a missed dose, ramipril 10 mg versus irbesartan 300mg.
Secondary Endpoints
Change From Baseline in Mean Sitting Systolic Blood Pressure (msSBP) to End of Study (Week 8)
Baseline, Week 8
Percentage of Participants Achieving Blood Pressure Control at Endpoint
8 weeks
Percentage of Participants Achieving a Successful Response Rate
8 weeks
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Study Design & Arms
AllocationRANDOMIZED
MaskingDOUBLE
ModelFACTORIAL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
PlaceboPLACEBO_COMPARATORIn order to adequately blind the study, patients were required to take a total of 3 tablets and 2 capsules of study medication throughout the study. In single blind run-in (4 weeks) and double blind treatment period (8 weeks), patients were received matching placebo of aliskiren/amlodipine 150/5 mg tablet, aliskiren/amlodipine 150/2.5 mg tablet, aliskiren 150 mg tablet and two amlodipine 2.5 mg capsules once daily.
Aliskiren 150 mgACTIVE_COMPARATORIn order to adequately blind the study, patients were required to take a total of 3 tablets and 2 capsules of study medication throughout the study. Patients received Aliskiren 150 mg tablet once daily (o.d)+ placebo of two amlodipine 2.5 mg capsule o.d., aliskiren/amlodipine 150/5 mg tablet o.d , aliskiren/amlodipine 150/2.5 mg tablet o.d for 8 weeks of double blind period.
Amlodipine 2.5 mgACTIVE_COMPARATORIn order to adequately blind the study, patients were required to take a total of 3 tablets and 2 capsules of study medication throughout the study. Patients received Amlodipine 2.5 mg capsule once daily (o.d)+ placebo of amlodipine 2.5 mg capsule o.d., Aliskiren 150 mg o.d., aliskiren/amlodipine 150/5 mg tablet o.d , aliskiren/amlodipine 150/2.5 mg tablet o.d for 8 weeks of double blind period.
Amlodipine 5 mgACTIVE_COMPARATORIn order to adequately blind the study, patients were required to take a total of 3 tablets and 2 capsules of study medication throughout the study. Patients received amlodipine 5 mg (two amlodipine 2.5 mg capsules o.d.)+ placebo of aliskiren 150 mg tablet o.d., aliskiren/amlodipine 150/5 mg tablet o.d. , aliskiren/amlodipine 150/2.5 mg tablet o.d. for 8 weeks of double blind period.
Aliskiren/amlodipine 150/2.5 mgEXPERIMENTALIn order to adequately blind the study, patients were required to take a total of 3 tablets and 2 capsules of study medication throughout the study. Patients received aliskiren/amlodipine 150/2.5 mg tablet o.d. + placebo of two amlodipine 2.5 mg capsules o.d., aliskiren 150 mg tablet o.d., aliskiren/amlodipine 150/5 mg tablet o.d. for 8 weeks of double blind period.
Aliskiren/amlodipine 150/5 mgEXPERIMENTALIn order to adequately blind the study, patients were required to take a total of 3 tablets and 2 capsules of study medication throughout the study. Patients received aliskiren/amlodipine 150/5 mg tablet o.d. + placebo of two amlodipine 2.5 mg capsules o.d., aliskiren 150 mg tablet o.d., aliskiren/amlodipine 150/2.5 mg tablet o.d. for 8 weeks of double blind period.
Non responder Olmesartan/AmlodipineEXPERIMENTALAliskiren/Amlodipine and Aliskiren/Amlodipine/HCTZ
Aliskiren/Amlodipine/HydrochlorothiazideEXPERIMENTALParticipants received aliskiren 300 milligrams (mg) plus hydrochlorothiazide 12.5 mg for one week, at Week 1 followed by combination of aliskiren 300 mg plus amlodipine 5 mg plus hydrochlorothiazide 12.5 mg for one week, at Week 2. Following Week 2, participants were force titrated up to aliskiren 300 mg plus amlodipine 10 mg plus hydrochlorothiazide 25 mg for 26 to 52 weeks (Weeks 28 to 54). All study medications were taken orally with water, once daily in the morning.
Interventions
NameTypeDescription
Aliskiren/Amlodipine 150/2.5 mgDRUGAliskiren/amlodipine 150/2.5 mg tablet
Aliskiren/amlodipine 150/5 mgDRUGAliskiren/amlodipine 150/5 mg tablet
Aliskiren 150 mgDRUGAliskiren 150 mg tablet
Amlodipine 2.5 mgDRUGAmlodipine 2.5 mg capsule
Placebo of AliskirenDRUGAliskiren placebo tablet
Placebo of AmlodipineDRUGAmlodipine placebo capsule
Placebo of Aliskiren/amlodipine 150/2.5 mgDRUGAliskiren/amlodipine 150/2.5 mg placebo tablet
Placebo of Aliskiren/amlodipine 150/5 mgDRUGAliskiren/amlodipine 150/5 mg placebo tablet
Aliskiren/Amlodipine and Aliskiren/Amlodipine/HCTZDRUGAliskiren 300 mg / Amlodipine 10 mg/HCTZ 12.5 mg
AliskirenDRUG300 mg tablet
AmlodipineDRUG5 mg tablet
HydrochlorothiazideDRUG12.5 mg and 25 mg capsule
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Eligibility Criteria
Age Range20 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites11

Inclusion Criteria: * Patients with essential hypertension (msDBP ≥ 95 mmHg and \< 110 mmHg and msSBP ≥140 mmHg ) * Outpatients Exclusion Criteria: * Severe hypertension (msDBP ≥110 mmHg and/or msSBP ≥ 180 mmHg) * History of allergy or hypersensitivity to renin inhibitors, calcium channel blocker...

Countries:JapanGermanyUnited StatesBelgiumEgyptPolandSlovakiaSpainTurkey (Türkiye)Switzerland
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