- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02626169
The Effect of Ticagrelor on 15-Epi-Lipoxin A4 and Inflammation
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Clopidogrel, ticagrelor and prasugrel are routinely used for platelet inhibition in addition to aspirin in patients after acute coronary syndromes. The platelet inhibition and patient outcomes (PLATO) trial showed that in patients with acute coronary syndromes, ticagrelor significantly reduced the primary endpoint (cardiovascular death, myocardial infarction or stroke), all-cause mortality and cardiovascular mortality compared to clopidogrel. On the other hand, when compared with clopidogrel in patients with acute coronary syndromes with scheduled percutaneous coronary intervention, prasugrel therapy did not affect overall mortality despite the fact that it was associated with significantly reduced rates of ischemic events, including stent thrombosis, but with an increased risk of major bleeding, including fatal bleeding. This may suggest that ticagrelor possesses additional (pleiotropic) effects besides platelet inhibition.
The investigators have recently shown that pioglitazone increases 15-epi-lipoxin A4 blood levels in patients. The investigators have recently found that in the rat, ticagrelor increases tissue levels of 15-epi-lipoxin A4 in the heart, aorta and kidney.
It is plausible that some of the favorable effects of ticagrelor seen in the clinical studies are mediated via the anti-inflammatory effects of 15-epi-lipoxin A4.
15-epi-lipoxin A4 is a potent anti-inflammatory and inflammation-resolving mediator derived from arachidonic acid. Several studies have suggested that ticagrelor has anti-inflammatory properties in various animal models. In the present study the investigators will assess if ticagrelor increases blood 15-epi-lipoxin A4 levels at doses used in patients.
Study Type
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77030
- Baylor College of Medicine
-
Houston, Texas, United States, 77030
- Baylor Clinic
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Provision of informed consent prior to any study specific procedures
Women of childbearing potential must be using an acceptable method of contraception to avoid pregnancy throughout the study
Patients with stable coronary artery disease (3-12 months after Acute Coronary Syndrome) who receive clopidogrel for at least 3 months.
Exclusion Criteria:
Recent stroke or acute coronary syndromes (<3 months before randomization).
Concurrent use of aspirin >100 mg/day where the dose reduction to 81 mg/day is contraindicated.
Current use of theophylline.
Concurrent use of Non Steroidal Anti-Inflammatory Drugs.
Patients receiving the following medications: ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir, telithromycin, rifampin, dexamethasone, phenytoin, carbamazepine, or phenobarbital. Patients receiving simvastatin or lovastatin at doses greater than 40 mg daily.
Patients with type 2 diabetes with a fasting plasma glucose greater than 200 mg/dl.
Active inflammatory disease or chronic infection.
Contraindication for aspirin, clopidogrel or ticagrelor.
Women who are pregnant or breastfeeding.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Clopidogrel
Clopidogrel 75 mg once a day by mouth for 30 days
|
Clopidogrel 75 mg once a day by mouth for 30 days
Other Names:
|
Active Comparator: Ticagrelor
Ticagrelor 90 mg twice daily by mouth for 30 days
|
Ticagrelor 90 mg twice daily by mouth for 30 days
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Plasma levels of 15-epi-lipoxin A4
Time Frame: 30 days
|
Percent change in plasma levels of 15-epi-lipoxin A4 from baseline (%)
|
30 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Plasma levels of C Reactive Protein (CRP)
Time Frame: 30 days
|
Percent changes in plasma CRP from baseline (%)
|
30 days
|
platelet aggregation in blood sample
Time Frame: 30 days
|
Percentage change in inhibition of platelet aggregation in blood sample from baseline (%)
|
30 days
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Yochai Birnbaum, MD, Baylor College of Medicine, Houston
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Cardiovascular Diseases
- Vascular Diseases
- Arteriosclerosis
- Arterial Occlusive Diseases
- Inflammation
- Atherosclerosis
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Platelet Aggregation Inhibitors
- Purinergic P2Y Receptor Antagonists
- Purinergic P2 Receptor Antagonists
- Purinergic Antagonists
- Purinergic Agents
- Ticagrelor
- Clopidogrel
Other Study ID Numbers
- H-33860
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Atherosclerosis
-
University Hospital, CaenUnknownPeripheral Arterial Disease | Atherosclerosis Obliterans | Atherosclerosis Right Leg | Atherosclerosis Left LegFrance
-
Nantes University HospitalAbbottCompletedAtherosclerosis ObliteransFrance
-
Central Hospital, Nancy, FranceSuspended
-
Federal University of São PauloCompletedAtherosclerosis of ArteryBrazil
-
MedtronicActive, not recruitingAtherosclerosis of Femoral Artery | Obstructive Disease | Atherosclerosis of Popliteal ArteryFrance
-
Cabinet de Medecine Interne Générale Demetrio PitarchCompletedAtherosclerosis of Artery
-
Emory UniversityThe Robert W. Woodruff FoundationCompleted
-
Korea UniversityMinistry of Health & Welfare, KoreaCompletedAtherosclerosis | Noninvasive Imaging of AtherosclerosisKorea, Republic of
-
Zhejiang Zylox Medical Device Co., Ltd.RecruitingAtherosclerosis of Femoral ArteryGermany
-
VA Office of Research and DevelopmentCompletedSaphenous Vein Graft AtherosclerosisUnited States
Clinical Trials on Clopidogrel
-
Korea University Anam HospitalCompleted
-
Chinese PLA General HospitalUnknownCLOPIDOGREL, POOR METABOLISM of (Disorder)China
-
Ospedale San DonatoCompletedAcute Myocardial InfarctionItaly
-
University of PecsTerminatedStable Angina Pectoris | Ad Hoc Percutaneous Coronary InterventionHungary
-
Hospital Central San Luis Potosi, MexicoUnknownAcute Coronary Syndrome
-
Lady Reading Hospital, PakistanPakistan Chest Society, PakistanRecruitingCOPD | COPD Exacerbation AcutePakistan
-
Deutsches Herzzentrum MuenchenTerminatedCoronary Artery DiseaseGermany
-
University of North Carolina, Chapel HillCompleted
-
Seung-Jung ParkCardioVascular Research Foundation, KoreaCompleted
-
University of PecsHungarian Academy of Sciences; KRKACompletedCoronary Heart Disease | Percutaneous Coronary Intervention