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Phase 3 N=57 Randomized Double-blind Treatment

Effects of Titrated Oral Tolvaptan 15-60 mg Once Daily (QD) on Cognitive and Neurological Function in Elderly Hyponatremic Patients

Hyponatremia

Enrolled (actual)
57
Serious AEs
5.3%
Results posted
Apr 2011
Primary outcome: Primary: Change From Baseline in the Neurocognitive Composite Score of Speed Domains (NCS-SD; Sum of All Correct Speed Domain Z-Scores) — 0.20; 0.39 Z-score — p=0.08

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Tolvaptan (Drug); Placebo (Drug)
Age
Adult, Older Adult · 50+ yrs
Sex
All
Sponsor
Otsuka Pharmaceutical Development & Commercialization, Inc.
Primary completion
Feb 2009

Outcome Measures

OutcomeResultp-value
PRIMARY
Change From Baseline in the Neurocognitive Composite Score of Speed Domains (NCS-SD; Sum of All Correct Speed Domain Z-Scores)
0.20; 0.39 0.08
SECONDARY
Change From Baseline to Day 22 in the Individual Neurocognitive Domains Included in the Primary Endpoint: Reaction Time in Computer Tests
0.21; 0.33 0.21
SECONDARY
Change From Baseline in the Individual Neurocognitive Domains Included in the Primary Endpoint: Psychomotor Speed Via Morse Tapping Test
0.04; 0.31 0.02 sig
SECONDARY
Change From Baseline in the Individual Neurocognitive Domains Included in the Primary Endpoint: Processing Speed of Rapid Visual Information Processing Test, Numeric Working Memory Test, and Word Recognition Test
0.24; 0.48 0.21
SECONDARY
Change From Baseline in Overall Neurocognitive Composite Score
0.19; 0.30 0.16
SECONDARY
Change From Baseline in Gait Test (Timed Get-Up-and-Go Test)
1.06; -0.43 0.23
SECONDARY
Change From Baseline in Postural Stability Test
1.3; -0.35 0.18
SECONDARY
Change From Baseline in Serum Sodium; ITT Population
2.23; 7.04 <0.0001 sig
SECONDARY
Number of Patients With Vital Sign Abnormalities: Blood Pressure
2; 0
SECONDARY
Number of Patients With Vital Sign Abnormalities: Pulse Rate
0; 0
SECONDARY
Number of Patients With Vital Sign Abnormalities: Body Weight
1; 1
SECONDARY
Number of Patients With Vital Sign Abnormalities: Body Temperature
1; 0
SECONDARY
Number of Patients With Hematology Laboratory Abnormalities: Hemoglobin
0; 1
SECONDARY
Number of Patients With Hematology Laboratory Abnormalities: Activated Partial Thromboplastin Time (aPTT)
1; 3
SECONDARY
Number of Patients With Hematology Laboratory Abnormalities: Lymphocytes
1; 2
SECONDARY
Number of Patients With Hematology Laboratory Abnormalities: Neutrophils
2; 0
SECONDARY
Number of Patients With Serum Chemistry Laboratory Abnormalities: Blood Urea Nitrogen (BUN)
1; 2
SECONDARY
Number of Patients With Serum Chemistry Laboratory Abnormalities: Uric Acid
0; 1
SECONDARY
Number of Patients With Serum Chemistry Laboratory Abnormalities: Cholesterol
0; 2
SECONDARY
Number of Patients With Serum Chemistry Laboratory Abnormalities: Glucose
2; 0
SECONDARY
Number of Patients With Serum Chemistry Laboratory Abnormalities: Magnesium
0; 1
SECONDARY
Number of Patients With Electrocardiogram (ECG) Abnormalities: QT >500 Milliseconds (Msec)
1; 0
SECONDARY
Number of Patients With Electrocardiogram (ECG) Abnormalities: QRS Interval
1; 1
SECONDARY
Number of Patients With Electrocardiogram (ECG) Abnormalities: QTcB Increase 30-60 Msec
3; 4
SECONDARY
Number of Patients With Electrocardiogram (ECG) Abnormalities: QTcF Increase 30-60 Msec
2; 3
SECONDARY
Number of Patients With Electrocardiogram (ECG) Abnormalities: ST Segment
0; 2
SECONDARY
Number of Patients With Electrocardiogram (ECG) Abnormalities: T Wave
1; 1
SECONDARY
Number of Patients With Electrocardiogram (ECG) Abnormalities: Right Bundle Branch Block (RBBB), Left Bundle Branch Block (LBBB), Myocardial Infarction (MI)
0; 1
SECONDARY
Number of Patients With Electrocardiogram (ECG) Abnormalities: Arrhythmia
2; 6

Summary

Demonstrate an improvement in the composite scores of validated neurocognitive tests in elderly subjects with chronic sub-clinical (i.e., asymptomatic) hyponatremia.

Eligibility Criteria

Inclusion Criteria

  • Women and men 50 years of age or older.
  • Serum Sodium ≥123 and ≤ 134 mEq/L [mmol/L]at screening and baseline.
  • Subjects with serum sodium concentrations ≥118 and ≤122 mEq/L[mmol/L] at screening and baseline may be entered into the trial based on consultation and approval from the study medical monitor.

Exclusion Criteria

  • Conditions or history which may present a safety concern to the subject or their offspring or extreme susceptibility to hypotension with sudden fluid loss (aquaresis).
  • Hyponatremia that is acute, easily reversible, artifactual, or due to a condition not associated with vasopressin excess or likely to respond to aquaretic therapy.
  • Conditions associated with an independent imminent risk of morbidity and mortality.
  • Conditions which may confound the assessment of endpoints, history of poor compliance, participation in a clinical trial believed by the PI or Sponsor likely to confound endpoint assessments.
  • Conditions which may confound primary endpoints of cognitive function.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00550459). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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