Efficacy of Lapaquistat Acetate Co-Administered With Statins in Subjects With Hypercholesterolemia

A Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of Lapaquistat Acetate 50 mg or Placebo When Co-administered With Statins in Subjects With Hypercholesterolemia, With an Optional Open-Label Extension

The purpose of the study is to determine the efficacy of lapaquistat acetate, once daily (QD), taken with statins on cholesterol levels in subjects with hypercholesterolemia

Study Overview

• Status: Terminated
• Conditions: Hypercholesterolemia
• Intervention / Treatment: Drug: Lapaquistat acetate and stable statin therapy; Drug: Stable statin therapy

Detailed Description

Dyslipidemias are a group of metabolic disorders produced by raised concentrations of lipoproteins, especially low-density lipoprotein cholesterol, which is the lipoprotein that transports endogenous cholesterol from the liver to the peripheral tissues. Increased cholesterol and triglycerides levels lead to an increased risk of arteriosclerosis, which is the underlying cause of heart attack, strokes and peripheral vascular disease.

Despite changes in lifestyle and the availability of potent lipid-lowering agents, cardiovascular disease continues to be the major cause of death in Western Europe and North America. Serum cholesterol levels exceeding 5 mmol/L (193 mg/dL) are common in adults in Britain and much of Europe, the United States, Australia and New Zealand.

This study will evaluate the efficacy and safety of lapaquistat acetate taken with either torvastatin, simvastatin, rosuvastatin, pravastatin, fluvastatin or lovastatin (stable statin therapy) in subjects with hypercholesterolemia. Total participation time in this study is expected to be up to 12 weeks, with an optional, 48-week, open-label extension period for participants who qualify.

• Study Type: Interventional
• Enrollment (Actual): 411
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Birmingham, Alabama, United States
    • Huntsville, Alabama, United States
    • Mobile, Alabama, United States
    • Tuscaloosa, Alabama, United States
  • Arizona
    • Chandler, Arizona, United States
    • Gilbert, Arizona, United States
    • Glendale, Arizona, United States
    • Tucson, Arizona, United States
  • California
    • Artesia, California, United States
    • Long Beach, California, United States
    • Santa Ana, California, United States
    • Santa Rosa, California, United States
    • Tustin, California, United States
    • Walnut Creek, California, United States
  • Colorado
    • Colorado Springs, Colorado, United States
    • Golden, Colorado, United States
  • District of Columbia
    • Washington, District of Columbia, United States
  • Florida
    • Coral Gables, Florida, United States
    • Ft. Meyers, Florida, United States
    • Hollywood, Florida, United States
    • Jacksonville, Florida, United States
    • Miami, Florida, United States
    • New Port Richey, Florida, United States
    • Pembroke Pines, Florida, United States
    • Pensacola, Florida, United States
    • Pinellas Park, Florida, United States
    • Sarasota, Florida, United States
    • St. Petersburg, Florida, United States
    • West Palm Beach, Florida, United States
  • Georgia
    • Dunwoody, Georgia, United States
  • Idaho
    • Idaho Falls, Idaho, United States
  • Illinois
    • Aurora, Illinois, United States
    • Chicago, Illinois, United States
  • Indiana
    • Evansville, Indiana, United States
    • Indianapolis, Indiana, United States
  • Iowa
    • Iowa City, Iowa, United States
  • Kansas
    • Overland Park, Kansas, United States
    • Wichita, Kansas, United States
  • Kentucky
    • Louisville, Kentucky, United States
  • Maine
    • CantonAuburn, Maine, United States
    • Scarborough, Maine, United States
  • Maryland
    • Baltimore, Maryland, United States
  • Massachusetts
    • Haverhill, Massachusetts, United States
  • Michigan
    • Ann Arbor, Michigan, United States
  • Minnesota
    • Brooklyn Center, Minnesota, United States
    • Edina, Minnesota, United States
  • Mississippi
    • Olive Branch, Mississippi, United States
  • Missouri
    • St. Louis, Missouri, United States
  • Montana
    • Billings, Montana, United States
  • New Jersey
    • Margate, New Jersey, United States
    • Wilwood, New Jersey, United States
  • North Carolina
    • Asheville, North Carolina, United States
    • Charlotte, North Carolina, United States
    • Durham, North Carolina, United States
    • Hickory, North Carolina, United States
    • Raleigh, North Carolina, United States
    • Salisbury, North Carolina, United States
    • Statesville, North Carolina, United States
    • Wilmington, North Carolina, United States
    • Winston Salem, North Carolina, United States
  • Ohio
    • Cincinnati, Ohio, United States
    • Kettering, Ohio, United States
    • Mentor, Ohio, United States
    • Zanesville, Ohio, United States
  • Oklahoma
    • Oklahoma City, Oklahoma, United States
  • Oregon
    • Portland, Oregon, United States
  • Pennsylvania
    • Altoona, Pennsylvania, United States
    • Dowington, Pennsylvania, United States
    • Sellerville, Pennsylvania, United States
  • Rhode Island
    • Warwick, Rhode Island, United States
  • South Carolina
    • Goose Creek, South Carolina, United States
    • Greer, South Carolina, United States
    • Mt Pleasant, South Carolina, United States
    • Mt. Pleasant, South Carolina, United States
    • Simpsonville, South Carolina, United States
  • Tennessee
    • Bristol, Tennessee, United States
  • Texas
    • Austin, Texas, United States
    • Corpus Christi, Texas, United States
    • Dallas, Texas, United States
    • Houston, Texas, United States
    • Irving, Texas, United States
    • San Antonio, Texas, United States
  • Utah
    • Salt Lake City, Utah, United States
  • Virginia
    • Burke, Virginia, United States
    • Norfolk, Virginia, United States
    • Richmond, Virginia, United States
  • Wisconsin
    • Wauwatosa, Wisconsin, United States

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Females of childbearing potential who are sexually active must agree to use adequate contraception from screening throughout the duration of the study and for 30 days following the last dose.
• Has been on a stable dose of statin for at least 3 months prior to Screening. Participants enrolled in Canada, Latin America, and South Africa must be on the maximum approved dose of statin (atorvastatin 80 mg, simvastatin 80 mg, rosuvastatin 40 mg, pravastatin 80 mg, fluvastatin 80 mg, or lovastatin 80 mg).
• Prior to Randomization, the participant has a mean low density lipoprotein cholesterol level greater than or equal to 100 mg/dL and less than or equal to 190 mg/dL for 2 consecutive samples.
• Prior to Randomization, the subject has mean triglyceride level greater than or equal to 400 mg/dL for 2 consecutive samples.
• Is willing and able to comply with the recommended, standardized diet.

Exclusion Criteria:

• Has an nine aminotransferase or aspartate aminotransferase level greater than 1.5 times the upper limit of normal, identified during screening.
• Has a serum creatinine greater than 133 mmol/L, identified during screening.
• Has a creatine kinase greater than 3 times the upper limit of normal, identified during screening.
• Has active liver disease or jaundice.
• Has taken any bile acid sequestrants [eg, cholestyramine], and intestinal cholesterol uptake inhibitors [eg, ezetimibe]) from 30 days before Screening until study completion or any fibrates for 6 weeks before Visit 1.
• Has a previous history of cancer that has been in remission for less than 5 years prior to the first dose of study medication.
• Has an endocrine disorder, such as Cushing's syndrome, hyperthyroidism, or inappropriately treated hypothyroidism affecting lipid metabolism.
• Has a history of myocardial infarction, angina pectoris, unstable angina, transient ischemic attacks, cerebrovascular accident, peripheral vascular disease, abdominal aortic aneurysm, coronary angioplasty, coronary or peripheral arterial surgery, or multiple risk factors that confer a 10-year risk for cardiovascular heart disease greater than 20% based on Framingham risk scoring.
• Has a positive hepatitis B surface antigen or hepatitis C virus antibody test, as determined by medical history.
• Has a positive human immunodeficiency virus status or is taking antiretroviral medications, as determined by medical history and/or subject's verbal report.
• Has received any investigational medication 30 days prior to screening, (for drugs with a long half-life, within a period of less than 5 times the drug's half-life) or is participating in an investigational study.
• Has received lapaquistat acetate in a previous clinical study or as a therapeutic agent.
• Has a history or presence of clinically significant food allergy that would prevent adherence to the specialized diet.
• Has a known heterozygous or homozygous familial hypercholesterolemia or known type III hyperlipoproteinemia (familial dysbetalipoproteinemia).
• Has fibromyalgia, myopathy, rhabdomyolysis, or unexplained muscle pain.
• Has uncontrolled hypertension
• Has had inflammatory bowel disease or any other malabsorption syndrome, or has had gastric bypass or any other surgical procedure for weight loss.
• Has a history of drug abuse or a history of high alcohol intake within the previous 2 years.
• Has type 1 or 2 diabetes mellitus.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Stable statin therapy	Drug: Stable statin therapy; Lapaquistat acetate placebo-matching tablets, orally, once daily and stable statin therapy for up to 12 weeks.; Other Names: Crestor; Zocor; Lipitor; Mevacor; Pravachol; Lescol
Experimental: Lapaquistat Acetate 50 mg QD; (and stable statin therapy)	Drug: Lapaquistat acetate and stable statin therapy; Lapaquistat acetate 50 mg, tablets, orally, once daily and stable statin therapy for up to 12 weeks.; Other Names: Crestor; Zocor; Lipitor; Mevacor; TAK-475; Pravachol; Lescol

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Change from Baseline in fasting plasma Low Density Lipoprotein cholesterol	Week 12 or Final Visit

Secondary Outcome Measures

Outcome Measure	Time Frame
Change from Baseline in Triglycerides	Week 12 or Final Visit
Change from Baseline in Total Cholesterol	Week 12 or Final Visit
Change from Baseline in apolipoprotein A1	Week 12 or Final Visit
Change from Baseline in apolipoprotein B	Week 12 or Final Visit
Change from Baseline in non- High Density Lipoprotein cholesterol	Week 12 or Final Visit
Change from Baseline in High Density Lipoprotein cholesterol	Week 12 or Final Visit
Change from Baseline in Very Low Density Lipoprotein cholesterol	Week 12 or Final Visit
Change from Baseline in the ratio of Total Cholesterol/High Density Lipoprotein cholesterol	Week 12 or Final Visit
Change from Baseline in the ratio of apolipoprotein A1/apolipoprotein B	Week 12 or Final Visit
Change from Baseline in high-sensitivity C-reactive protein	Week 12 or Final Visit
Change from Baseline in the ratio of Low Density Lipoprotein cholesterol/High Density Lipoprotein cholesterol	Week 12 or Final Visit
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 1.81 mmol/L (70 mg/dL)	Week 12 or Final Visit
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 2.59 mmol/L (100 mg/dL)	Week 12 or Final Visit
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 3.37 mmol/L (130 mg/dL)	Week 12 or Final Visit

Collaborators and Investigators

• Sponsor: Takeda

Study record dates

Study Major Dates

• Study Start: July 1, 2007
• Primary Completion (Actual): April 1, 2008
• Study Completion (Actual): April 1, 2008

Study Registration Dates

• First Submitted: September 18, 2007
• First Submitted That Met QC Criteria: September 19, 2007
• First Posted (Estimate): September 20, 2007

Study Record Updates

• Last Update Posted (Estimate): June 22, 2016
• Last Update Submitted That Met QC Criteria: June 20, 2016
• Last Verified: June 1, 2016

More Information

Terms related to this study

• Keywords: Drug Therapy; Hyperlipidemia
• Additional Relevant MeSH Terms: Metabolic Diseases; Lipid Metabolism Disorders; Hyperlipidemias; Dyslipidemias; Hypercholesterolemia; Molecular Mechanisms of Pharmacological Action; Enzyme Inhibitors; Antimetabolites; Anticholesteremic Agents; Hypolipidemic Agents; Lipid Regulating Agents; Atorvastatin; Rosuvastatin Calcium; Pravastatin; Simvastatin; Lovastatin; L 647318; Dihydromevinolin; Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Other Study ID Numbers: TAK-475_307; U1111-1122-8479 (Registry Identifier: WHO)