Endothelin Antagonism in ANCA Vasculitis
The Vascular Effects of Endothelin Receptor Antagonism in Systemic Vasculitis
Patients with vasculitis commonly develop cardiovascular disease. The reasons for this are not clear and is not adequately treated with current drugs. It is thus understand the reasons why patients with vasculitis develop cardiovascular disease in order to develop new drugs to reduced this risk.
Endothelin is a chemical produced by blood vessels that contributes to the development of hypertension and cardiovascular disease Higher than normal levels of endothelin are seen in patients with vasculitis but how this contributes to cardiovascular disease in patients with vasculitis is not clear. By using drugs that block the effects of endothelin ('endothelin receptor antagonists') the investigators can hopefully reduce the risk of cardiovascular disease in patients with vasculitis. The purpose of the study is to ascertain if endothelin receptor antagonists improve blood vessel function in patients with vasculitis.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Vasculitis patients and healthy controls matched for age, sex will be enrolled into the study. Patients will attend for 4 study days >1 week apart, whereas controls will attend for single day. Circulating Mφ and other immune cells will be confirmed using FACS prior each study.
Study 1 Both patients and control will attend for visit 1: assessment of vascular function using forearm plethysmography as part of case control study.
Vasculitis patients will then attend for visits 2, 3 & 4 as part of randomised three way crossover study (randomised & infusions given in a double-blind method): comparison of the effects of selective ETA receptor antagonism (BQ123; 1000nmol/min for 15min iv), mixed ETA/B antagonism (BQ123/788; 1000 nmol/min & 300 nmol/min for 15 min), and placebo on systemic haemodynamics.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Edinburgh, United Kingdom
- University of Edinburgh
-
-
Midlothian
-
Edinburgh, Midlothian, United Kingdom, EH16 4TJ
- University of Edinburgh
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female
- Age 18 years and over
- Body mass index ≤35
- Normal serum albumin
Exclusion Criteria:
- Subject with diabetes or current smoking or chronic kidney disease (eGFR <60ml/min)
- Subject with pre-existing cardiovascular disease
- Subject is below the age of legal consent, or is mentally or legally incapacitated
- History of multiple and/or severe allergic reactions to drugs (including study drugs)
- The subject has donated blood (450 ml) within the last 4 weeks
- Past or present drug or alcohol abuse including intravenous drug abuse at any time
- Participation in another clinical trial within 1 month
- Considered to be at high risk of HIV or hepatitis B
- Women of child-bearing potential (only women who are post-menopausal or surgically-sterilised will be included in the study)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo
Saline placebo
|
Intravenous infusion of saline
Other Names:
|
|
Experimental: BQ123
Intravenous infusion of BQ123 1000nmol/min for 15min
|
Intravenous infusion of BQ123 ( selective ETA antagonist )
Other Names:
|
|
Experimental: BQ123/788
Intravenous infusion of BQ123 1000nmol/min and BQ788 300nmol/min
|
or BQ123/788 (mixed ETA/B antagonists)
Other Names:
|
|
No Intervention: Assessment of forearm vascular function
Response of forearm blood flow to endothelium-dependent and endothelium-independent vasodilators
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Study 1 - forearm blood flow
Time Frame: 20mins
|
Response to endothelium-dependent vasodilators
|
20mins
|
|
Study 2 - pulse wave velocity
Time Frame: 4 hours
|
Response of participants to ET antagonism
|
4 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Study 1 - tPA release
Time Frame: 20min
|
Response of fibrinolytic system to endothelial vasodilators
|
20min
|
|
Study 1 - baseline pulse wave velocity
Time Frame: Baseline
|
Baseline arterial stiffness
|
Baseline
|
|
Study 2 - tPA release
Time Frame: 4 hours
|
Response of participants to ET antagonism
|
4 hours
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Neeraj Dhaun, University of Edinburgh
Study record dates
Study Major Dates
Study Start
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Bean ICRF clinical study
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