Comparative Effects of Nebivolol and Metoprolol on Femal Sexual Function
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Purpose
Beta-blockers (BB) are an important treatment for high blood pressure and heart disease. However beta-blockers can cause sexual dysfunction (SD) and this common side effect limits successful use of this class of medications. Sexual side effects often result in drug discontinuation, compromising therapy goals. The investigators are conducting the study to determine if nebivolol, a newer beta blocker that is selective for receptors in the heart and causes vasodilation in the body causes fewer sexual side effects, or even improves sexual function, compared with metoprolol succinate.
| Condition | Intervention |
|---|---|
|
Hypertension Female Sexual Dysfunction |
Drug: nebivolol and metoprolol succinate Drug: metoprolol succinate and nebivolol |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Comparative Effects of Nebivolol and Metoprolol on Femal Sexual Function |
- Change in FSF and CSFQ, two validated questionnaires for assessment of sexual function. [ Time Frame: Every 12 weeks. ] [ Designated as safety issue: No ]
- The effects of nebivolol and metoprolol on sexual function and to compare the effects of both drugs on vitality, work and life performance, and work and life satisfaction. [ Time Frame: Every 4 weeks. ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 80 |
| Study Start Date: | October 2009 |
| Estimated Study Completion Date: | April 2013 |
| Estimated Primary Completion Date: | April 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm A
Nebivolol 5 mg daily for 12 weeks followed by Metoprolol succinate 100 mg daily for 12 weeks. A two week washout (no medication) is completed prior to switching to metoprolol.
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Drug: nebivolol and metoprolol succinate
Subjects randomized to treatment Arm A will receive nebivolol 5 mg once daily for 12 weeks. After 12 weeks, double blind therapy will be discontinued and patients will undergo a wash-out period of study therapy over 2 weeks. Subjects randomized to treatment Arm A will then receive metoprolol succinate 100 mg once daily. Subjects will continue double blind therapy for a total duration of 12 weeks.
Other Names:
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Experimental: Arm B
Metoprolol succinate 100 mg daily for 12 weeks followed by nebivolol 5 mg daily for 12 weeks. A two week washout (no medication) is completed prior to switching to nebivolol.
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Drug: metoprolol succinate and nebivolol
Subjects randomized to treatment Arm B will receive metoprolol succinate 100mg once daily for 12 weeks. After 12 weeks, double blind therapy will be discontinued and patients will undergo a wash-out period of study therapy over 2 weeks. Subjects randomized to treatment Arm B will then receive nebivolol 5 mg once daily. Subjects will continue double blind therapy for a total duration of 12 weeks.
Other Names:
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Detailed Description:
This protocol is designed to compare the effects two beta blockers, nebivolol (Bystolic) 5-10 mg daily with metoprolol succinate (Toprol XL) 100-200 mg daily on sexual function in post-menopausal women with high blood pressure. The study is composed of 2 treatment phases. At baseline subjects are randomized to either nebivolol 5 mg once daily or metoprolol succinate 100 mg once daily. After randomization, subjects are treated for 12 weeks with double blind therapy. Following double-blind therapy subjects enter a 2-week washout phase and are subsequently switched to the alternate therapy.
After 4 weeks (visits 3 and 7) of double-blind treatment with either nebivolol 5 mg once daily or metoprolol succinate 100 mg once daily subjects will be evaluated and the need for dosage titration assessed. If blood pressure is not at goal the dosage of study medication will be doubled to nebivolol 10 mg once daily or metoprolol succinate 200 mg once daily. If blood pressure remains uncontrolled after 8 weeks of double blind treatment with study medication open label amlodipine 5 mg will be initiated (visits 4 and 8) at the discretion of the principal investigator. During double blind treatment subjects will be evaluated in clinic every 4 weeks.
The primary efficacy variable is the change from baseline in Changes in Sexual Functioning Questionnaire (CSFQ) and the Female Sexual Function Index (FSFI).
The primary study objective is to determine whether nebivolol causes fewer sexual side effects compared with metoprolol succinate and if nebivolol improves FSF in women. FSF will be assessed with the above questionnaires-FSFI and CSFQ.
Eligibility| Ages Eligible for Study: | 40 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Over the age of 40 years
- Postmenopausal (according to self report of 12 consecutive months of amenorrhea, serum FSH concentrations greater than 40 international units/L, or surgical history consistent with menopause)
- In a stable monogamous relationship with a male partner for at least 6 months
- History of hypertension, treated or untreated
- Requirement for the initiation of an anti-hypertensive agent OR addition of another anti-hypertensive medication (according to the principal investigator and based on clinical judgment) OR patients requiring monotherapy with an anti-hypertensive that wish to participate in the study and are willing to undergo a two week wash-out of current anti-hypertensive therapy
- Provide written informed consent prior to participation.
Exclusion Criteria:
- Properly measured clinic SBP > 170 mmHg
- Advanced AV block
- Severe hepatic disease
- Heart rate < 55 beats/min (and not currently on beta blocker therapy)
- Pregnancy or lactation
- Heart failure with ejection fraction less than 0.40
- History of myocardial infarction
- History of Raynaud's syndrome
- Patients with alcoholism or recreational drug use will be excluded due to concerns about the ability to comply with the study requirements.
- Major psychiatric disorder not well controlled with treatment
- Spinal cord injury
- Severe respiratory disease, which in the opinion of the investigator contraindicates BB treatment
- Poorly controlled diabetes mellitus (≥ 9%)
- Persistent arrhythmia
Contacts and Locations| Contact: Benjamin Epstein, PharmD | 904-854-1354 | benjamin.epstein@eastcoastresearch.net |
| Contact: Nancy Hart, PharmD | 904-384-2240 | nancy.hart@eastcoastresearch.net |
| United States, Florida | |
| Family Practice | Recruiting |
| Jacksonville, Florida, United States, 32204 | |
| Contact: Nancy Hart, PharmD 904-384-2240 ext 4280 nancy.hart@eastcoastresearch.net | |
| Principal Investigator: Benjamin J Epstein, PharmD | |
| Sub-Investigator: Rebecca K Meiners, MD | |
| Sub-Investigator: Boyd D Evans, MD | |
| Sub-Investigator: Vaughn R Meiners, MD | |
| Principal Investigator: | Benjamin Epstein, PharmD | East Coast Institute for Research |
More Information
Additional Information:
No publications provided
| Responsible Party: | Benjamin Epstein, Principal Investigator, East Coast Institute for Research |
| ClinicalTrials.gov Identifier: | NCT00995072 History of Changes |
| Other Study ID Numbers: | SAIRB-09-0011 |
| Study First Received: | October 12, 2009 |
| Last Updated: | August 13, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by East Coast Institute for Research:
|
sexual dysfunction female hypertension high blood pressure beta blockers |
metoprolol nebivolol Bystolic Toprol XL |
Additional relevant MeSH terms:
|
Sexual Dysfunctions, Psychological Sexual and Gender Disorders Hypertension Vascular Diseases Cardiovascular Diseases Mental Disorders Metoprolol Nebivolol Metoprolol succinate Anti-Arrhythmia Agents Cardiovascular Agents Therapeutic Uses Pharmacologic Actions |
Antihypertensive Agents Sympatholytics Autonomic Agents Peripheral Nervous System Agents Physiological Effects of Drugs Adrenergic beta-1 Receptor Antagonists Adrenergic beta-Antagonists Adrenergic Antagonists Adrenergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Vasodilator Agents |
ClinicalTrials.gov processed this record on June 17, 2013