CLUE

A randomized comparative effectiveness trial of IV nicardipine versus labetalol uwse in the emergency department

W. F. Peacock, Joseph Varon, Brigitte M. Baumann, Pierre Borczuk, Chad M. Cannon, Abhinav Chandra, David M. Cline, Deborah Diercks, Brian Hiestand, A. Hsu, Preeti Jois-Bilowich, Brian Kaminski, Philip Levy, Richard M. Nowak, Jon W. Schrock

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Introduction: Our purpose was to compare the safety and efficacy of food and drug administration (FDA) recommended dosing of IV nicardipine versus IV labetalol for the management of acute hypertension.Methods: Multicenter randomized clinical trial. Eligible patients had 2 systolic blood pressure (SBP) measures ≥180 mmHg and no contraindications to nicardipine or labetalol. Before randomization, the physician specified a target SBP ± 20 mmHg (the target range: TR). The primary endpoint was the percent of subjects meeting TR during the initial 30 minutes of treatment.Results: Of 226 randomized patients, 110 received nicardipine and 116 labetalol. End organ damage preceded treatment in 143 (63.3%); 71 nicardipine and 72 labetalol patients. Median initial SBP was 212.5 (IQR 197, 230) and 212 mmHg (IQR 200,225) for nicardipine and labetalol patients (P = 0.68), respectively. Within 30 minutes, nicardipine patients more often reached TR than labetalol (91.7 vs. 82.5%, P = 0.039). Of 6 BP measures (taken every 5 minutes) during the study period, nicardipine patients had higher rates of five and six instances within TR than labetalol (47.3% vs. 32.8%, P = 0.026). Rescue medication need did not differ between nicardipine and labetalol (15.5 vs. 22.4%, P = 0.183). Labetalol patients had slower heart rates at all time points (P < 0.01). Multivariable modeling showed nicardipine patients were more likely in TR than labetalol patients at 30 minutes (OR 2.73, P = 0.028; C stat for model = 0.72). Conclusions: Patients treated with nicardipine are more likely to reach the physician-specified SBP target range within 30 minutes than those treated with labetalol.Trial registration: ClinicalTrials.gov: NCT00765648.

Original languageEnglish (US)
Article numberR157
JournalCritical Care
Volume15
Issue number3
DOIs
StatePublished - Jun 27 2011

Fingerprint

Labetalol
Nicardipine
Hospital Emergency Service
Blood Pressure
Physicians
United States Food and Drug Administration
Random Allocation
Randomized Controlled Trials
Heart Rate

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Peacock, W. F., Varon, J., Baumann, B. M., Borczuk, P., Cannon, C. M., Chandra, A., ... Schrock, J. W. (2011). CLUE: A randomized comparative effectiveness trial of IV nicardipine versus labetalol uwse in the emergency department. Critical Care, 15(3), [R157]. https://doi.org/10.1186/cc10289

CLUE : A randomized comparative effectiveness trial of IV nicardipine versus labetalol uwse in the emergency department. / Peacock, W. F.; Varon, Joseph; Baumann, Brigitte M.; Borczuk, Pierre; Cannon, Chad M.; Chandra, Abhinav; Cline, David M.; Diercks, Deborah; Hiestand, Brian; Hsu, A.; Jois-Bilowich, Preeti; Kaminski, Brian; Levy, Philip; Nowak, Richard M.; Schrock, Jon W.

In: Critical Care, Vol. 15, No. 3, R157, 27.06.2011.

Research output: Contribution to journalArticle

Peacock, WF, Varon, J, Baumann, BM, Borczuk, P, Cannon, CM, Chandra, A, Cline, DM, Diercks, D, Hiestand, B, Hsu, A, Jois-Bilowich, P, Kaminski, B, Levy, P, Nowak, RM & Schrock, JW 2011, 'CLUE: A randomized comparative effectiveness trial of IV nicardipine versus labetalol uwse in the emergency department', Critical Care, vol. 15, no. 3, R157. https://doi.org/10.1186/cc10289
Peacock, W. F. ; Varon, Joseph ; Baumann, Brigitte M. ; Borczuk, Pierre ; Cannon, Chad M. ; Chandra, Abhinav ; Cline, David M. ; Diercks, Deborah ; Hiestand, Brian ; Hsu, A. ; Jois-Bilowich, Preeti ; Kaminski, Brian ; Levy, Philip ; Nowak, Richard M. ; Schrock, Jon W. / CLUE : A randomized comparative effectiveness trial of IV nicardipine versus labetalol uwse in the emergency department. In: Critical Care. 2011 ; Vol. 15, No. 3.
@article{3300fb04627c46789f0cfd8ec9c7e103,
title = "CLUE: A randomized comparative effectiveness trial of IV nicardipine versus labetalol uwse in the emergency department",
abstract = "Introduction: Our purpose was to compare the safety and efficacy of food and drug administration (FDA) recommended dosing of IV nicardipine versus IV labetalol for the management of acute hypertension.Methods: Multicenter randomized clinical trial. Eligible patients had 2 systolic blood pressure (SBP) measures ≥180 mmHg and no contraindications to nicardipine or labetalol. Before randomization, the physician specified a target SBP ± 20 mmHg (the target range: TR). The primary endpoint was the percent of subjects meeting TR during the initial 30 minutes of treatment.Results: Of 226 randomized patients, 110 received nicardipine and 116 labetalol. End organ damage preceded treatment in 143 (63.3{\%}); 71 nicardipine and 72 labetalol patients. Median initial SBP was 212.5 (IQR 197, 230) and 212 mmHg (IQR 200,225) for nicardipine and labetalol patients (P = 0.68), respectively. Within 30 minutes, nicardipine patients more often reached TR than labetalol (91.7 vs. 82.5{\%}, P = 0.039). Of 6 BP measures (taken every 5 minutes) during the study period, nicardipine patients had higher rates of five and six instances within TR than labetalol (47.3{\%} vs. 32.8{\%}, P = 0.026). Rescue medication need did not differ between nicardipine and labetalol (15.5 vs. 22.4{\%}, P = 0.183). Labetalol patients had slower heart rates at all time points (P < 0.01). Multivariable modeling showed nicardipine patients were more likely in TR than labetalol patients at 30 minutes (OR 2.73, P = 0.028; C stat for model = 0.72). Conclusions: Patients treated with nicardipine are more likely to reach the physician-specified SBP target range within 30 minutes than those treated with labetalol.Trial registration: ClinicalTrials.gov: NCT00765648.",
author = "Peacock, {W. F.} and Joseph Varon and Baumann, {Brigitte M.} and Pierre Borczuk and Cannon, {Chad M.} and Abhinav Chandra and Cline, {David M.} and Deborah Diercks and Brian Hiestand and A. Hsu and Preeti Jois-Bilowich and Brian Kaminski and Philip Levy and Nowak, {Richard M.} and Schrock, {Jon W.}",
year = "2011",
month = "6",
day = "27",
doi = "10.1186/cc10289",
language = "English (US)",
volume = "15",
journal = "Critical Care",
issn = "1466-609X",
publisher = "Springer Science + Business Media",
number = "3",

}

TY - JOUR

T1 - CLUE

T2 - A randomized comparative effectiveness trial of IV nicardipine versus labetalol uwse in the emergency department

AU - Peacock, W. F.

AU - Varon, Joseph

AU - Baumann, Brigitte M.

AU - Borczuk, Pierre

AU - Cannon, Chad M.

AU - Chandra, Abhinav

AU - Cline, David M.

AU - Diercks, Deborah

AU - Hiestand, Brian

AU - Hsu, A.

AU - Jois-Bilowich, Preeti

AU - Kaminski, Brian

AU - Levy, Philip

AU - Nowak, Richard M.

AU - Schrock, Jon W.

PY - 2011/6/27

Y1 - 2011/6/27

N2 - Introduction: Our purpose was to compare the safety and efficacy of food and drug administration (FDA) recommended dosing of IV nicardipine versus IV labetalol for the management of acute hypertension.Methods: Multicenter randomized clinical trial. Eligible patients had 2 systolic blood pressure (SBP) measures ≥180 mmHg and no contraindications to nicardipine or labetalol. Before randomization, the physician specified a target SBP ± 20 mmHg (the target range: TR). The primary endpoint was the percent of subjects meeting TR during the initial 30 minutes of treatment.Results: Of 226 randomized patients, 110 received nicardipine and 116 labetalol. End organ damage preceded treatment in 143 (63.3%); 71 nicardipine and 72 labetalol patients. Median initial SBP was 212.5 (IQR 197, 230) and 212 mmHg (IQR 200,225) for nicardipine and labetalol patients (P = 0.68), respectively. Within 30 minutes, nicardipine patients more often reached TR than labetalol (91.7 vs. 82.5%, P = 0.039). Of 6 BP measures (taken every 5 minutes) during the study period, nicardipine patients had higher rates of five and six instances within TR than labetalol (47.3% vs. 32.8%, P = 0.026). Rescue medication need did not differ between nicardipine and labetalol (15.5 vs. 22.4%, P = 0.183). Labetalol patients had slower heart rates at all time points (P < 0.01). Multivariable modeling showed nicardipine patients were more likely in TR than labetalol patients at 30 minutes (OR 2.73, P = 0.028; C stat for model = 0.72). Conclusions: Patients treated with nicardipine are more likely to reach the physician-specified SBP target range within 30 minutes than those treated with labetalol.Trial registration: ClinicalTrials.gov: NCT00765648.

AB - Introduction: Our purpose was to compare the safety and efficacy of food and drug administration (FDA) recommended dosing of IV nicardipine versus IV labetalol for the management of acute hypertension.Methods: Multicenter randomized clinical trial. Eligible patients had 2 systolic blood pressure (SBP) measures ≥180 mmHg and no contraindications to nicardipine or labetalol. Before randomization, the physician specified a target SBP ± 20 mmHg (the target range: TR). The primary endpoint was the percent of subjects meeting TR during the initial 30 minutes of treatment.Results: Of 226 randomized patients, 110 received nicardipine and 116 labetalol. End organ damage preceded treatment in 143 (63.3%); 71 nicardipine and 72 labetalol patients. Median initial SBP was 212.5 (IQR 197, 230) and 212 mmHg (IQR 200,225) for nicardipine and labetalol patients (P = 0.68), respectively. Within 30 minutes, nicardipine patients more often reached TR than labetalol (91.7 vs. 82.5%, P = 0.039). Of 6 BP measures (taken every 5 minutes) during the study period, nicardipine patients had higher rates of five and six instances within TR than labetalol (47.3% vs. 32.8%, P = 0.026). Rescue medication need did not differ between nicardipine and labetalol (15.5 vs. 22.4%, P = 0.183). Labetalol patients had slower heart rates at all time points (P < 0.01). Multivariable modeling showed nicardipine patients were more likely in TR than labetalol patients at 30 minutes (OR 2.73, P = 0.028; C stat for model = 0.72). Conclusions: Patients treated with nicardipine are more likely to reach the physician-specified SBP target range within 30 minutes than those treated with labetalol.Trial registration: ClinicalTrials.gov: NCT00765648.

UR - http://www.scopus.com/inward/record.url?scp=79959572700&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79959572700&partnerID=8YFLogxK

U2 - 10.1186/cc10289

DO - 10.1186/cc10289

M3 - Article

VL - 15

JO - Critical Care

JF - Critical Care

SN - 1466-609X

IS - 3

M1 - R157

ER -