Drug Therapy Induced Weight Loss to Improve Blood Vessel Function in Subjects With Obesity (REVIVE)
Does Reversal of Visceral Obesity by Drug Therapy Improve Vascular Function?
Obesity is common (>30% of US adults), contributes to substantial morbidity and mortality, but is difficult to treat. Partly this is due to the transient, arduous and modest nature of lifestyle interventions. Partly it is due to the limited efficacy and safety problems of existing pharmacotherapy. Only one drug, orlistat, is approved for long-term use in obesity; but its effects on weight are relatively small. There are drugs that have been approved for other diseases but which also reduce weight. One promising approach to treating obesity is combination therapy with orlistat and one or more of these other agents. The investigators propose an innovative approach to developing new therapies for obesity coupling the use of combination therapy with rigorous assessment of cardiovascular safety. Vascular function is a quantitative surrogate clinical endpoint that has been strongly and independently linked to future cardiovascular events.
Our hypothesis is that combination pharmacotherapy will reduce weight and improve vascular function in obese human subjects. The co-primary endpoints will be weight and vascular function.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Iowa
-
Iowa City, Iowa, United States, 52241
- University of Iowa Hospitals and Clinics
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 40 to 75 years
- Male or postmenopausal female
- BMI ≥ 30 kg/m2
- One or more major cardiovascular (CV) risk factors (hypertension, dyslipidemia, impaired glucose tolerance OR metabolic syndrome)
Exclusion Criteria:
- Congestive heart failure
- Renal impairment
- History of bariatric surgery (i.e. lap-band, Roux-en-Y or biliopancreatic diversion)
- Type I diabetes mellitus
- Weight loss > 10% in the past 6 months
- Recurrent nephrolithiasis
- Current treatment for seizure disorder
- Hepatic cirrhosis
- Current use of study medications
- Current use of oral estrogen
- History of smoking cessation in the past three months
- Current cholestasis or malabsorption syndrome
- Planned use of any herbal or over-the-counter supplements for weight loss
- History of allergic reactions to metformin, topiramate, orlistat or any of ingredients
- Medical conditions requiring continuous use of phosphodiesterase inhibitors and/or the inability to withhold phosphodiesterase inhibitors for 48 hours
- Participation in another clinical drug study within four weeks prior to this investigation.
- Participation in any other weight loss or rigorous exercise program.
- Any disease or condition that in the opinion of the investigator may interfere with completion of the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo
|
Placebo pills and capsules for metformin, orlistat and topiramate
|
|
Experimental: Topiramate
|
|
|
Active Comparator: Metformin
|
|
|
Experimental: Metformin + Orlistat
|
|
|
Experimental: Metformin + Topiramate
|
|
|
Experimental: Metformin + Topiramate + Orlistat
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Weight (Percent Change From Baseline)
Time Frame: Baseline and 6 months
|
Weight obtained in the fasting state on a gowned subject.
|
Baseline and 6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Office Systolic Blood Pressure (mmHg Change From Baseline)
Time Frame: Baseline and 6 months
|
Automated sphygmomanometry while sitting
|
Baseline and 6 months
|
|
Centimeter Change in Waist Circumference
Time Frame: Baseline and 6 months
|
Waist circumference for central adiposity
|
Baseline and 6 months
|
|
Carotid-femoral Pulse Wave Velocity (PWV)(Change After 6 Months From Baseline)
Time Frame: Baseline and 6 months
|
Change in carotid-femoral pulse wave velocity in meters/second (Sphygmocor).
|
Baseline and 6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Gary L Pierce, PhD, University of Iowa
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Vascular Diseases
- Cardiovascular Diseases
- Nutrition Disorders
- Metabolic Diseases
- Overnutrition
- Body Weight
- Glucose Metabolism Disorders
- Insulin Resistance
- Hyperinsulinism
- Overweight
- Lipid Metabolism Disorders
- Hyperglycemia
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Signs and Symptoms
- Obesity
- Hypertension
- Metabolic Syndrome
- Dyslipidemias
- Glucose Intolerance
- Organic Chemicals
- Carbohydrates
- Lactones
- Sugars
- Biguanides
- Guanidines
- Amidines
- Hexoses
- Monosaccharides
- Fructose
- Ketoses
- Topiramate
- Orlistat
- Metformin
Other Study ID Numbers
Other Study ID Numbers
- 201012738
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