- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02772640
Effectiveness of Treatment of Hypercholesterolemia With Rosuvastatin and Ezetimibe (ROSEZE)
The Impact of the Time of Drug Administration on the Effectiveness of Combined Treatment of Hypercholesterolemia With ROSuvastatin and EZEtimibe (ROSEZE) - A Single-center, Crossover, Open-label Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The current guidelines recommend statins as drugs of first choice in the treatment of hypercholesterolemia. If the target LDL cholesterol is not achieved, combination of a statin with a cholesterol absorption inhibitor -ezetimibe may be considered.
According to meta-analyzes of studies assessing statins, each 1.0 mmol / L (~ 40 mg / dL) reduction in LDL-C corresponds to a 10% reduction in all-cause mortality and a 20% reduction in the number of deaths from coronary artery disease. Each 1 mmol / L (40 mg / dL) reduction in LDL-C also translates into a 23% and 17% reduction of the risk of major coronary events and stroke, respectively. Similar results concerning the efficacy and safety of lipid-lowering therapy using statins were obtained in meta-analyzes of studies on primary prevention. Statins are a heterogenous group of drugs with respect to their LDL-C reduction power. So far, the most potent statin is rosuvastatin. Despite intensive statin therapy provided, a large group of patients still does not reach therapeutic goals. Statin dose titration seems to be less effective compared with the combined therapy with statin and ezetimibe. The combination of statin with ezetimibe reduces the LDL-C by additional 15-20%.
Tablets comprising both of these drugs (statin and ezetimibe) simplify the drug administration and increase the probability of drug compliance. This may increase the probability for achieving therapeutic goals in hypercholesterolemia treatment.
Taking into account the metabolism of cholesterol and possible drug-drug interactions it is recommended to administer simvastatin in the evening. Rosuvastatin may be administer at any time of the day.
The study is designed as an open-label, single-center, cross-over study evaluating the effectiveness of combined therapy with rosuvastatin and ezetimibe for hypercholesterolemia depending on timing of the day of administration of the study treatment. After enrollment the participants will be allocated into two arms, each receiving rosuvastatin and ezetimibe. The study drug (rosuvastatin with ezetimibe) will be given: 1) in the morning (8:00) for 6 weeks and then in the evening for the next 6 weeks; 2) in the evening (20:00) for the first 6 weeks and then in the morning for the following 6 weeks. The change in total cholesterol and LDL-cholesterol at 6 and 12 weeks of the tested therapy will be measured as the primary outcome of the study. Moreover, other parameters including: HDL-cholesterol, triglycerides, apolipoprotein B (ApoB), ApoAI, nonHDL-cholesterol, sd-LDL-cholesterol, lipoprotein (a), glucose, HBA1c, high sensitivity C reactive protein (hsCRP), ALT, aspartate aminotransferase (AST), creatine kinase (CK ) will be assessed as secondary outcomes.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
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Kujawsko-Pomorskie
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Bydgoszcz, Kujawsko-Pomorskie, Poland, 85-094
- Cardiology Department, Dr. A. Jurasz University Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Hypercholesterolemia
- Ineffectiveness of statin monotherapy in the treatment of hypercholesterolemia after at least 6 weeks
Exclusion Criteria:
- Active liver disease
- Unexplained persistent increase in serum transaminase levels, including more than 3 times the upper limit of normal activity of one of them
- Severe renal impairment (creatinine clearance <30 ml / min)
- Myopathy
- Concomitant treatment with cyclosporine, gemfibrozil
- Pregnancy
- Lactation
- Women of childbearing age not using effective methods of contraception
- Symptoms of muscle damage after using statins or fibrates in the past.
- The activity of creatine kinase> 5 times the upper limit of normal
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Arm I: R+E morning->evening
Rosuvastatin and Ezetimibe morning or evening administration: Rosuvastatin (R) plus Ezetimibe (E) administration in the morning (8:00) for 6 weeks.
After 6 weeks - intervention - change of the timing of study drug administration to the evening hours (20:00).
|
Timing of the drug administration: morning -> evening evening -> morning
Other Names:
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Active Comparator: ARM II: R+E evening->morning
Rosuvastatin and Ezetimibe evening or morning administration: Rosuvastatin (R) plus Ezetimibe (E) administration in the evening (20:00) for 6 weeks.
After 6 weeks - intervention - change of the timing of study drug administration to the morning hours (8:00).
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Timing of the drug administration: morning -> evening evening -> morning
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in total cholesterol and LDL-Cholesterol
Time Frame: 6 and 12 weeks
|
Change in total cholesterol and LDL-Cholesterol at 6 and 12 weeks of study drug treatment (combination of ezetimibe and rosuvastatin), depending on the time of day of study drug administration
|
6 and 12 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in HDL-Cholesterol
Time Frame: 6 and 12 weeks
|
Change in HDL-Cholesterol at 6 and 12 weeks of study drug treatment (combination of ezetimibe and rosuvastatin), depending on the time of day of study drug administration
|
6 and 12 weeks
|
Change in triglycerides
Time Frame: 6 and 12 weeks
|
Change in triglycerides at 6 and 12 weeks of study drug treatment (combination of ezetimibe and rosuvastatin), depending on the time of day of study drug administration
|
6 and 12 weeks
|
Change in apolipoproteins ApoB, APO AI
Time Frame: 6 and 12 weeks
|
Change in apolipoproteins ApoB, APO AI at 6 and 12 weeks of study drug treatment (combination of ezetimibe and rosuvastatin), depending on the time of day of study drug administration
|
6 and 12 weeks
|
Change in non - HDL-Cholesterol
Time Frame: 6 and 12 weeks
|
Change in non - HDL-Cholesterol at 6 and 12 weeks of study drug treatment (combination of ezetimibe and rosuvastatin), depending on the time of day of study drug administration
|
6 and 12 weeks
|
Change in sd-LDL-Cholesterol
Time Frame: 6 and 12 weeks
|
Change in sd-LDL-Cholesterol at 6 and 12 weeks of study drug treatment (combination of ezetimibe and rosuvastatin), depending on the time of day of study drug administration
|
6 and 12 weeks
|
Change in lipoprotein (a)
Time Frame: 6 and 12 weeks
|
Change in lipoprotein (a) at 6 and 12 weeks of study drug treatment (combination of ezetimibe and rosuvastatin), depending on the time of day of study drug administration
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6 and 12 weeks
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Assessment of change of glucose concentration
Time Frame: Baseline, 6 and 12 weeks
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Assessment of glucose at baseline and at 6 and 12 weeks of treatment with study drug
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Baseline, 6 and 12 weeks
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Assessment of HbA1c
Time Frame: Baseline, 6 and 12 weeks
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Assessment of HbA1c at baseline and at 6 and 12 weeks of treatment with study drug
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Baseline, 6 and 12 weeks
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Assessment of hsCRP
Time Frame: Baseline, 6 and 12 weeks
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Assessment hsCRP at baseline and at 6 and 12 weeks of treatment with study drug
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Baseline, 6 and 12 weeks
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Assessment of ALT
Time Frame: Baseline, 6 and 12 weeks
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Assessment ALT at baseline and at 6 and 12 weeks of treatment with study drug
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Baseline, 6 and 12 weeks
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Assessment of AST
Time Frame: Baseline, 6 and 12 weeks
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Assessment AST at baseline and at 6 and 12 weeks of treatment with study drug
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Baseline, 6 and 12 weeks
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Assessment of CK
Time Frame: Baseline, 6 and 12 weeks
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Assessment CK at baseline and at 6 and 12 weeks of treatment with study drug
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Baseline, 6 and 12 weeks
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Assessment of plasma fluorescence using stationary and time-resolved spectrofluorimetry
Time Frame: Baseline, 6 and 12 weeks
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Assessment of plasma fluorescence using stationary and time-resolved spectrofluorimetry at baseline, at 6 and 12 weeks of treatment with study drug
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Baseline, 6 and 12 weeks
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jacek Kubica, MD, PhD, Collegium Medicum w Bydgoszczy
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
- Metabolic Diseases
- Lipid Metabolism Disorders
- Hyperlipidemias
- Dyslipidemias
- Hypercholesterolemia
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antimetabolites
- Anticholesteremic Agents
- Hypolipidemic Agents
- Lipid Regulating Agents
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Rosuvastatin Calcium
- Ezetimibe
Other Study ID Numbers
- AMI9
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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.
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